Vision Service Plan

Coverage from Vision Service Plan (VSP) features a large national network of vision providers. Many vision service providers at Barnes-Jewish Hospital and Washington University are in the VSP Network.

Key Features

Covers a well vision exam with a copayment for child(ren) up to 18 twice a year, and adults once a year
Pays a portion of the cost for your contacts or eye-glass lenses once a calendar year
Pays a portion of the cost for children’s (up to 18) frames once a calendar year, and the cost of adult frames every other year
Provides a discount on laser vision correction

To find a provider, visit VSP or call toll-free 800.877.719.

Vision Coverage Chart

	VSP Provider	Non-Network
WellVision Exam® (twice every calendar year for child(ren) up to 18; once every calendar year for adults)	$15 copayment	Up to $45 after $15 copayment
Contacts (once every calendar year instead of lenses and frames)	Up to $200	Up to $105
Contact Lens Exam, Fitting & Evaluation	$60 copayment	N / A
Lenses - (once every calendar year)
Single Vision	100% after $15 copayment	Up to 45% after $15 copayment
Lined Bifocal	100% after $15 copayment	Up to 65% after $15 copayment
Lined Trifocal	100% after $15 copaymen	Up to 85% after $15 copayment
Frames (once every calendar year for child(ren) up to 18; once every other calendar year for adults)	Up to $200 after $15 copayment	Up tp $47 after $15 copayment
Laser Vision Correction	Average 15% discount	N / A

Employee Costs for Vision Coverage The contributions listed below are pre-tax, per-pay-period deductions, based on 26 pay periods a year.

	Full-Time & Part-Time
Employee Only	$3.58
Employee + Children	$8.13
Employee + Spouse	$7.17
Employee + Family	$13.00

An annual preventive vision exam is covered at 100 percent under the BJC Medical Plan. Present your Cigna medical ID card at the time of service. ID Cards

VSP does not issue ID cards. The network provider needs only your social security number to verify your benefits and submit claims.