2013 VSP Choice Vision Insurance
Evidence of Coverage & Disclosure Form (Base Plan & Buy-Up Plan)
Evidence of Coverage & Disclosure Form (Executive Plan)
Vision care is just as important as medical care. The eyes can be a key to identifying other health related issues you may have. The City of Ontario offers two vision options to choose from. With the VSP Basic option, each member is allowed a vision exam every 12 months and frames and lenses every 24 months. The VSP Buy Up option allows a vision exam, frames and lenses every 12 months.
||VSP Buy Up
|Well Vision Eye Exam
||$20 Copay every 12 months
||$10 Copay Every 12 Months
||Free every 24 months
||Free every 12 months
||$120 allowance every 24 months, plus an additional 20% off any out-of-pocket expense
||$150 allowance every 12 months, plus an additional 20% off any out-of-pocket expense
||Up to $60 copay for contact lens exam (fitting and evaluation); $120 allowance every 24 months
||Up to $60 copay for contact lens exam (fitting and evaluation); $120 allowance every 12 months
VSP offers extra discounts on out-of-pocket costs. You will receive, on average, 20% on non-covered lens options and additional glasses and sunglasses, including lens options from any VSP doctor within 12 months of your last WellVision Exam.
VSP offers a discount on Laser Vision Correction. The discount is an average of 15% off the regular price or 5% off the promotional price. The discounts are only available from contracted facilities. After surgery, you may use your frame allowance (if eligible) for sunglasses from any VSP doctor. If you visit a non-VSP provider, your benefit may be reduced. Before seeing a non-VSP provider, call VSP at 1-800-877-7195 for more information and details.
Important information about 2013 vision insurance:
- No changes to existing VSP providers
- Depending upon your bargaining groups MOU, you may be able to waive your vision plan
- New Costco benefit added to existing VSP network
- Eye exam at plan copayment (NOTE: some optometrists may choose not to participate; member would be reimbursed non-network benefit allowance)
- $70 VSP Basic or $80 VSP Buy Up allowance for frames; lenses are covered
- $120 contact lens allowance (excluding contact lens exam)
- Reduced out-of-network allowances