Vision Insurance
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Focus® Plan Summary
| Deductibles | VSP Choice Network + Affiliates | Out of Network |
|---|---|---|
| $10 Exam $25 Eye Glass Lenses or Frames* |
$10 Exam $25 Eye Glass Lenses or Frames* |
|
| Annual Eye Exam | Covered in full | Upto $45 |
| Lenses (per pair) | ||
| Single Vision | Covered in full | Up to $30 |
| Bifocal | Covered in full | Up to $50 |
| Trifocal | Covered in full | Up to $65 |
| Lenticular | Covered in full | Up to $100 |
| Progressive | Covered in full | NA |
| Contacts | See lens options | |
| Fit & Follow Up Exams | Member cost up to $60 | No benefit |
| Elective | Up to $130 | Up to $105 |
| Medically Necessary | Covered in full | Up to $210 |
| Frames | $130* | Up to $70 |
| Frequencies (months) | 12/12/24 | 12/12/24 |
| Exam/Lens/Frame | Based on date of service | Based on date of service |
*Deductible applies to a complete pair of glasses or to frames, whichever is selected.
**The Costco allowance will be the wholesale equivalent.
Lens Options (member cost)*
| VSP Choice Network + Affiliates (Other than Costco) |
Out of Network | |
|---|---|---|
| Progressive Lenses | Up to provider’s contracted fee for Lined Bifocal Lenses. The patient is responsible for the difference between the base lens and the Progressive Lens charge. | Up to provider’s contracted fee for Lined Bifocal Lenses. |
| Std. Polycarbonate |
Covered in full for dependent children | No benefit |
| Solid Plastic Dye | $30 adults $15 (except Pink I & II) |
No benefit |
| Plastic Gradient Dye | $17 | No benefit |
| Photochromatic Lenses (Glass & Plastic) |
$31-$82 | No benefit |
| Scratch Resistant Coating | $17-$33 | No benefit |
| Anti-Reflective Coating | $43-$85 | No benefit |
| Ultraviolet Coating |
$16 | No benefit |
*Lens Option member costs vary by prescription, option chosen and retail locations.
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