VSP Provider BenefitsNon-VSP Provider Reimbursement Amounts
Vision  Exam
(once  per calendar year)
100% after $15 copayUp to $40
Eyeglass  Lenses
(once per calendar year)
100% after $15 copay1
Up to $40 (Single Vision)
Up to $60 (Bifocal)
Up to $80 (Trifocal)
Up to $125 (Lenticular)
Frames
Adult (every two calendar  years)
Child (once per calendar year)
100% after $15 copay
(up to $200)
Up to $40
Necessary  Contacts2
(once  per calendar year)
Contact Lens Evaluation,  Fitting Fees and Contact Lenses
100% after $15 copayUp to $210
Elective  Contacts3
(once  per calendar year)
Contact Lens Evaluation,  Fitting Fees and Contact Lenses
Up to $200Up to $105
(1) Special frames and tinted lenses will cost more.
(2) Necessary contacts—required after cataract surgery; to correct extreme acuity problems that cannot be corrected with glasses; for certain conditions of anisometropia and keratoconus.
(3) Elective contacts—for any other reason than stated above and are covered instead of lenses and frames.