Article 9: Vision Benefits >>

9.4 Using the Plan

To obtain vision care from the Vision Service Plan, do the following:

1. Contact the Health Benefits Department at the Administrative Office for a VSP brochure, or call your VSP doctor. If you need to locate a VSP doctor, call VSP at (800) 877-7195 or visit their web site at www.vsp.com. If you would like a list of VSP doctors (optometrists and ophthalmologists) near where you live, a list will be sent to you.
2. When making an appointment, identify yourself as a VSP member. The VSP doctor will also need the covered Participant's identification number (usually the Participant’s Social Security Number), and the covered Participant’s group name. The VSP doctor will contact VSP to verify your eligibility and Plan coverage. The VSP doctor will also obtain authorization for services and materials. If you are not eligible, the VSP doctor will notify you.
3. At your appointment, the VSP doctor will conduct an eye examination and determine if corrective eyewear is necessary. If so, the VSP doctor will submit your prescription to a VSP-approved, contract laboratory. The VSP doctor will itemize any non-covered charges and have you sign a form to document that you received the services. VSP will pay the VSP doctor directly, according to their contract agreement, less any co-payments you may be required to pay as set forth above.
4. Selecting a doctor from the VSP list assures direct payment to the doctor and a guarantee of quality and cost control. However, if you seek the services of a provider who is not a VSP doctor, you should pay the provider his/her full fee at the time of service and submit your receipts to VSP. VSP will reimburse you directly in accordance with the schedule of allowances. VSP will not reimburse the non-VSP provider.

There is no assurance that this schedule will be sufficient to pay for the examination or the glasses. When you obtain service from a provider who is not a VSP doctor, and/or glasses from a dispensing optician, be sure to mail your itemized statement of charges to VSP so VSP can reimburse you directly. All claims must be submitted within six (6) months of the date services are completed.