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Vision Service Plan

Regence BlueShield medical plans provide comprehensive vison coverage by contracting with Vision Service Plan (VSP).

When you use a VSP provider, you pay a $20 copay for exams and receive a frame allowance of $130. Service frequency limitations apply. If you choose to use an out-of-network provider, you are still eligible for the service reimbursement listed below.

VSP Providers

Eligible members can choose non-VSP providers, but using VSP providers may lower costs.

VSP-participating providers use Allowable Charges, meaning the provider will accept the plan’s payment plus your share.

Non-participating providers may charge more than the Allowable Charges, and you’ll be responsible for the extra amount, in addition to your deductible and coinsurance. An exception is made if the non-participating provider is used for emergencies or is the only option available.

To find VSP providers, contact Vision Service Plan at 1-800-877-7195 or visit their website, log in, and select “Find a VSP Doctor.”

In-Network Providers

Employee Coverage

Adults and dependents 19 years of age and older

Benefit Description Copay
WellVision® Exam Focuses on your eyes and overall wellness
Every 12 months 		$20
Prescription Glasses $20
Frame $130 allowance for a wide selection of frames
$150 allowance for featured frame brands
20% savings on the amount over your allowance
$70 Walmart/Sam’s Club/Costco® frame allowance
Every 24 months 		Included in Prescription Glasses
Lenses Single vision, lined bifocal and lined trifocal lenses
Impact-resistant lenses for dependent children
Every 12 months 		Included in Prescription Glasses
Lens Enhancements Standard progressive lenses
Premium progressive lenses
Custom progressive lenses
Average savings of 20-25% on other lens enhancements
Every 12 months 		$0
$95-$105
$150-$175
Contacts
(instead of glasses) 		$130 allowance for contacts; copay does not apply
Contact lens exam (fitting and evaluation) Every 12 months 		Up to $60
Out-of- Network Benefits Call Member Services for out-of-network details at 800-877-7195.
Extra Savings Get the most out of your benefits and greater savings with a VSP network doctor. Visit vsp.com/offers for information on additional savings and exclusive member extras available to VSP members.

Pediatric Coverage

Dependents younger than 19 years of age

Benefit Description Copay
WellVision® Exam Comprehensive WellVision Exam covered in full
Every 12 months 		$0
Prescription Glasses $0
Frame Covered-in-full frames from the Otis & Piper Eyewear CollectionTM
Available only through a VSP doctor.
Not available at retail locations.
Every 12 months
Included in Prescription Glasses
Lenses Impact-resistant plastic or glass lenses covered in full.
Single vision, lined bifocal, lined trifocal, or lenticular lenses covered in full.
Every 12 months 		Included in Prescription Glasses
Lens Enhancements The following lens enhancements are covered in full:
  • Scratch-resistant coating

  • Ultraviolet coating

Every 12 months 		Additional lens enhancements, covered after copay, save members an average 20 – 25%
Contacts (instead of glasses) Contact lens exam (fitting and evaluation):
  • Standard and premium fits are covered in full

Materials:
Prescription contact lenses covered with a minimum three-month supply for any of the following modalities:
  • Standard (one pair annually)
  • Monthly (six-month supply)
  • Bi-weekly (three-month supply)
  • Dailies (three-month supply)
  • Contact lenses are in lieu of frame and lenses

Every 12 months 		$0
Out-of- Network Benefits No retail or out-of-network benefit available.
Extra Savings Get the most out of your benefits and greater savings with a VSP network doctor. Visit vsp.com/offers for information on additional savings and exclusive member extras available to VSP members.