Where can I get an eye exam?Can I get both glasses and contacts?Is LASIK covered?
Network Options: VSP Choice Network
Vision insurance helps protect the health of your eyes, including routine visits to the optometrist for eye exams as well as coverage for glasses and contacts. Make sure your eyes remain in great shape at any age – no matter how much time you spend staring at digital screens.
(800) 541-7846 | guardiananytime.com | Group #00543619
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Vision Plan |
VSP CHOICE NETWORK
In-Network
Out-of-Network
Routine Vision Exams
$10 copay
Frequency
Exams
Once per calendar year
Contact Lenses
Once per calendar year
Frames
Once every other calendar year
Lenses
Once per calendar year
Eyeglasses
Single Vision Lenses 1
Plan pays 100% of covered services
Plan reimburses up to $23
Lined Bifocal Lenses 1
Plan pays 100% of covered services
Plan reimburses up to $37
Lined Trifocal Lenses 1
Plan pays 100% of covered services
Plan reimburses up to $49
Frame Allowance
Plan provides a $150 allowance 2
Plan reimburses up to $46
Contact Lenses
Prescription Medically Necessary
Plan pays 100% of covered services
Plan reimburses up to $210
Prescription Elective (in lieu of eyeglasses)
Plan provides a $150 allowance 3
Plan provides a $100 allowance
1 Limited to standard, uncoated plastic lenses. $25 copay applies to all materials.
2 A 20% discount is applied to frames over the $150 allowance
3 A 15% discount is applied to conventional contacts over the $150 allowance
2 A 20% discount is applied to frames over the $150 allowance
3 A 15% discount is applied to conventional contacts over the $150 allowance
EMPLOYEE COST PER PAY PERIOD
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
$0.54
$1.08
$0.92
$1.51
This information is designed to help you choose a benefit plan for 2024 only. Please refer to the Plan Documents provided by the carrier for information regarding coverage, limitations, and exclusions. If there is a difference between this guide and the Plan Documents, the Plan Documents prevail.
