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Summary Plan Description (SPD)
Using the Plan
To obtain vision care from the Vision Service Plan, do the following:
- Contact the Membership Services 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.
- When making an appointment, identify yourself as a VSP member. The VSP doctor will also need the covered member's identification number (usually the social security number), and the covered member'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.
- At your appointment, the VSP doctor will provide an eye examination and determine if eyewear is necessary. If so, the VSP doctor will coordinate the prescription with 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 services. VSP will pay the VSP doctor directly, according to their contract agreement, less any copayment as mentioned above.
- 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. You will be
reimbursed in accordance with the schedule of allowances.
There is no assurance that this schedule will be sufficient to pay for the examination or the glasses. Reimbursement benefits are not assignable. 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. All claims must be submitted within six months of completion of services.