Vision exam benefit

If you are enrolled in the PPO, EPO, or HDHP medical option, you and your covered family members will automatically be enrolled in the VSP vision exam benefit. You also have this benefit when enrolled in medical continuation coverage or if you have continued medical coverage through transitional participation.

The vision exam benefit covers annual routine eye exams and screenings related to certain health conditions. Your benefits will go further when you use network providers.

How it works

When you use an optometrist or ophthalmologist who participates in the VSP network, you pay a set copay (with no deductible) for covered services. Your benefit covers the rest of the cost.

  • $25 copay for an annual routine eye exam
  • $20 copay for exams and services to treat pink eye and sudden changes in vision or to monitor ongoing conditions such as dry eye, diabetic eye disease, glaucoma, and more. (Coordination with your medical benefits may apply. Ask your VSP provider for details.)
  • $20 copay for retinal screening if you are living with diabetes

To find participating VSP providers, search the VSP website or call VSP at 800-877-7195. You can maximize your benefits when using VSP Premier Edge locations, which include private practice doctors and Visionworks retail stores.

You also will receive discounts on vision-related items and services when you purchase them through a VSP network provider within 12 months of your last covered VSP WellVision Exam:

  • glasses
    • 20 percent savings on complete pair of prescription glasses and nonprescription glasses, including sunglasses*
  • contact lens exams
    • 15 percent savings on contact lens exams (fitting and evaluation; no discount on contact lenses)*
  • laser vision correction
    • average savings of 15 percent off regular price or 5 percent off promotional price (available only from contracted facilities)*

In addition to hundreds of retail chains in the VSP network, you have the option of purchasing frames from national VSP partners such as Costco Optical, Rx Optical, and Shopko. No discounts apply when purchasing frames from a VSP partner.

*Not available at retail chains.

Using your vision exam benefit

You don’t need an ID card to use this benefit. Simply tell your VSP network provider you have coverage through VSP and provide your date of birth, and the last four digits of your Social Security number. (Note: Covered family members should provide the employee’s name and date of birth and the last four digits of the employee’s Social Security number.)

If you’d like an ID card, you can download and print one by logging on to the VSP website.

Out-of-network benefits

If you choose to go to an out-of-network provider — an eye doctor that does not accept payment from VSP — you pay the full cost of your routine annual eye exam up front. Submit your out-of-network claim to VSP, and you'll be reimbursed up to $45 after your $25 copay is deducted.

To file claims

  • log on to the VSP website;
  • if prompted, select Board of Pensions Exam (Board of Pensions – Presbyterian Church) and click Continue to Plan;
  • click Benefits;
  • scroll down and click Submit a Claim; then
  • click Start New Claim and follow the instructions to upload your receipts.

You can also print and mail copies of your claim form and receipts to VSP. Log on to the VSP website for forms and instructions. You also can call Quantum Health at 855-497-1237 and a Care Coordinator can assist you.