|2017-18 VSP Member Information|
|Member ID||Your VSP ID number is the nine numbers after the "XDP" on your Anthem Blue Cross ID card.|
|2017-18 Vision Benefits Summary|
|VSP Choice Provider||Non-Network Provider|
|Eye exam (Once every plan year. Not including contact lens fitting.)||$10 co-pay||$47 allowance|
|Prescription glasses (once every plan year)||
● $25 co-pay + $150 allowance
|$45 allowance for frames, $30-$60 allowance for lens1|
|Contact lenses (in lieu of glasses, once every plan year)||$150 allowance||$100 allowance|
|Additional glasses or sunglasses, inlcuding lens enhancements||20% discount||N/A|
|Lasik or PRK refractive surgeries||15% discount (average)||N/A|
1Allowance depends on the type of lens.
Review for additional benefit details including frequency of coverage.
- Contact lens wearers may be subject to a contact lens evaluation fee or fitting fee.
- If lenses and frames or contact lenses are chosen which exceed the $150 allowance, the cost above $150 is the responsibility of the student.
- You are expected to pay the co-payment and other fees are the time of service. There are no claims to file for in-network providers.
- The following services or supplies are not covered by this vision plan: Orthoptics or vision training, non-prescription glasses or contact lenses, medical or surgical treatment of the eyes other than laser vision correction, non-FDA-approved vision services, treatment and materials, and any other service not listed above as a covered benefit.
Injury or illness of the eye will continue to be covered by the medical portion of SHIP, administered by Anthem Blue Cross.