Paying for Care
The entire cost of the VSP is paid by participants, who are responsible for the insurance premiums and applicable copayments for examinations and eyewear. Premiums are paid via bi-weekly pre-tax payroll deductions. The plan generally pays for prescription glasses, contact lenses and laser eye surgery, up to the applicable allowance. Prices are already discounted through VSP (www.vsp.com) network doctors.
Copayments
When a participant receives an eye exam from a VSP network doctor or a non-VSP provider, or obtains glasses or contacts, he or she is subject to the applicable copayment as shown in the table below.
When a participant receives services from a non-VSP provider, he or she is responsible for paying the complete bill at the time of service and applying for reimbursement for the benefits (less applicable copayments) according to the summary of benefits in the table that follows. For further information about what is covered and what is not covered by the plan, participants should contact VSP by calling 1-800-877-7195, or by visiting the VSP web site (www.vsp.com).
Summary of Benefits
Download the SAIC Vision Plan Summary of Benefits Table (16k)
| BENEFIT | FREQUENCY | VSP NETWORK DOCTOR | NON-VSP PROVIDER |
|---|---|---|---|
| Vision Exam | Once every calendar year | $20 copay then plan pays 100% for exam services and prescription glasses | $20 copay then plan pays up to $45 for exam services and prescription glasses |
| Lenses | Once every calendar year | Plan pays 100% for
single vision, lined bifocal, and lined trifocal lenses Lens options that enhance appearance, durability and function of glasses are available at up to a 20% discount | Plan reimburses up to: $45 for single vision $65 for lined bifocal $85 for lined trifocal $125 for lenticular |
| Frames | Once every other calendar year | Plan covers frames up to $120; participants may upgrade frames by paying the difference in cost; 20% discount on any out-of-pocket costs. | Plan reimburses up to $47 |
| Contacts (in lieu of lenses and frames) | Once every calendar year | Plan pays up to $120 allowance*; 15% discount on contact lens exam (fitting and evaluation) | Plan reimburses up to $105* |
| Medically necessary contact lenses** (in lieu of lenses and a frame) | Once every calendar year | Plan pays 100% if contact lenses are required for certain medical conditions that prevent a participant from wearing eyeglasses. Medically necessary contact lenses must be approved by VSP. | Reimbursed up to $210 |
| Laser Vision Correction | Plan pays $100 per eye up to a $200 maximum, plus plan provides discounts averaging 15% on charges not to exceed:
| Plan reimburses $100 per eye up to a $200 maximum; no discounts available |
* Applied both to contact lens fitting and evaluation and to contacts.
** Medically necessary contact lenses are covered in full, if required for certain medical conditions that prevent you from wearing eyeglasses. Medically necessary contact lenses must be approved by VSP.
