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County of Santa Clara

YOUR VSP

VISION BENEFITSMEMBERS FIRST,

MEMBERS FOR LIFE

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VSP PLAN AT A GLANCE

County of Santa Clara’s

VSP Choice Plan

Copays $20 Exam Copay and $20 Copay for Prescription Glasses

Exam WellVision Exam covered every 12 months

Frame Allowance $120 frame allowance every 24 months

LensesPolycarbonate lenses for dependent children along with single vision, lined bifocal and lined trifocal lenses

covered in full every 12 months

Lens EnhancementsStandard Progressives covered with $0 Copay

Savings on other lens enhancements of 20-25%

Contact Lens Allowance

(in lieu of glasses)$120 allowance for contact lenses. Up to $60 Copay for contact lens exam (fitting and evaluation)

Diabetic EyeCare PlusServices related to diabetic eye disease, glaucoma and age-related macular degeneration (AMD)

$20 Copay per visit

Retinal Screening No more than a $39 Copay on routine retinal screening as an enhancement to a WellVision Exam.

Extra Savings

• Extra $20 to spend on featured frame brands. 20% savings on additional glasses and sunglasses, including lens

enhancements, from any VSP provider within 12 months of your last WellVision Exam.

• No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam

• Laser Vision Correction: Average 15% off the regular price or 5% off the promotional price; discounts are

available from contracted facilities.

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BIG VALUE. MORE SAVINGS WITH VSP

VISION CARE.VSP puts members first by providing exclusive special offers from leading

industry brands. View Bonus Offers at vsp.com/offers

Special Deals: Extra $20 on Featured Frame Brands

and save up to 60% on Brand-name Hearing Aids from

TruHearing®

Premier Program locations offer:

• Access to exclusive Bonus Offers

• A wide selection of featured frame brands

• Eyewear protection warranty

• The latest in performance lenses

Eyeconic is the only place where VSP

members can shop online for contacts and

eyewear with their VSP insurance in network

Once you’re enrolled…

• Create an account at vsp.com and review your benefit information

• Find a VSP in-network doctor by visiting vsp.com or calling 800.877.7195

• No ID card needed, at your appointment, simply tell them you have VSP