Plan Details
Plan Name	VSP Core Plan
Effective Dates	Jan 01, 2022 to Dec 31, 2025
Benefits	In-Network	Out-of-Network
Exam Copay	$10	Up to $40 allowance
Materials Copay	$0	Based on fee schedule
Exam Frequency	Every calendar year	Every calendar year
Lenses Frequency	Every calendar year	Every calendar year
Frames Frequency	Every other calendar year	Every other calendar year
Contacts Frequency	Every calendar year	Every calendar year
Single Vision Lens	$0	Up to $30 allowance
Medically Necessary Contacts	Covered in Full	Not Covered
Elective Contacts	$130 allowance for contacts; copay does not apply	Up to $130 allowance
Frames	$150 frame allowance after $10 Copay	Up to $60 allowance
Corrective Vision Services (e.g. Laser Surgery)	Discount available	Not Covered
Second Pair of Glasses	Discount available	Not Covered