Vision
Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.
Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.
VSP Vision
Plan Information
Plan Name: VSP Vision Plan
Policy Number: 30032318
Effective Date: 01/01/2025
Provider Network: VSP
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Exams
$20 copay
Single Vision Lenses
$0 copay
Bifocal Lenses
$0 copay
Trifocal Lenses
$0 copay
Frames
Plan pays up to $200 allowance
Contacts (in lieu of glasses)
Plan pays up to $200 allowance ($60 copay for contact lens exam)
Lasik Benefit (in network only)
$2,300 Allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Out-of-Network Reimbursement
Exams
Plan pays up to $50
Single Vision Lenses
Plan pays up to $50
Bifocal Lenses
Plan pays up to $75
Trifocal Lenses
Plan pays up to $100
Frames
Plan pays up to $70
Contacts (in lieu of glasses)
Plan pays up to $105 (for lenses and exam)
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Plan Documents
Contact Information
BCBS Global Expat Vision
Plan Information
Plan Name: BCBS Global Expat PPO Vision
Policy Number: 4EL-7687-25
Effective Date: 01/01/2025
Provider Network: Blue Cross Blue Shield
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Vision Benefit Highlights
In-Network |
Out-of-Network Reimbursement |
|---|---|
| Exams | Exams |
| Plan pays 100% | Up to $XX |
| Single Vision Lenses | Single Vision Lenses |
| Plan pays 100% up to a maximum of $250 | Up to $XX |
| Bifocal Lenses | Bifocal Lenses |
| Plan pays 100% up to a maximum of $250 | Up to $XX |
| Trifocal Lenses | Trifocal Lenses |
| Plan pays 100% up to a maximum of $250 | Up to $XX |
| Frames | Frames |
| Plan pays 100% up to a maximum of $250 | Up to $XX |
| Contacts (in lieu of glasses) | Contacts (in lieu of glasses) |
| Plan pays 100% up to a maximum of $250 | Up to $XX |
Frequency |
Frequency |
|---|---|
| Exams | Exams |
| Once every 12 months | Once every 12 months |
| Lenses | Lenses |
| Once every 12 months | Once every 12 months |
| Frames | Frames |
| Once every 12 months | Once every 12 months |
| Contacts | Contacts |
| Once every 12 months | Once every 12 months |