Vision
The American Exchange vision plan provides coverage for an exam plus either frames or contacts. If you see an in-network provider, you pay a copay for your eye exam. The plan pays a benefit of up to $130 for frames or contact lenses. Additional copays apply for eyeglass lens options.
With the Principal vision plan, you may visit any vision provider. Using participating VSP providers will help you to maximize your benefits. You can find participating providers by going to: https://www.vsp.com/eye-doctor search for an Eye Doctor by entering your zip code or doctor’s name. When you visit a participating VSP vision provider, you will have a higher benefit and lower out-of-pocket costs, and you will receive the benefit at the time of service (no need to file claims). If you go out-of-network, you will need to pay at the time of service and file a claim for reimbursement.
| Vision Summary of Benefits | In-Network |
|---|---|
|
Exam
|
|
| Standard | $10 copay |
| Retinal Imaging | Up to $39 copay |
|
Lenses - Glasses
|
|
| Single | Covered in full after $25 copay |
| Bifocal | Covered in full after $25 copay |
| Trifocal | Covered in full after $25 copay |
| Lenticular | Covered in full after $25 copay |
|
Frames
|
$130 Allowance |
|
Contact Lenses
|
|
| Fit and Follow-up | Up to $60 Copay |
| Elective Lenses | $130 allowance |
| Medically necessary | Covered in full after $25 copay |
Frequency Limitation
This vision plan has frequency limitations. The exam benefit and lens benefit are once per 12 months. The frame benefit is once per 24 months.
Network
The Principal Vision plan uses the VSP network, effective 5/1/2022. Coverage can be verified by you or your provider by calling (800) 877-7195.
