Vision Benefits

WellVision Exam

$10 Copay

Up to $45

Once per calendar year

Laser Vision Correction
Discount

• Average 15% off the regular price or
5% off the promotional price

• Discounts only available from
contracted facilities

N/A

Once per eye per lifetime

Lenses

Single Vision Lined

$10
(lenses and frame)

Up to $30

Once per calendar year

Bifocal Lined

$10
(lenses and frame)

Up to $50

Once per calendar year

Trifocal

$10
(lenses and frame)

Up to $60

Once per calendar year

Lenticular

$10
(lenses and frame)

Up to $100

Once per calendar year

Necessary Contacts

$10
(lenses and frame)

Up to $210

Once per calendar year

Lens Enhancements

Standard progressive

No cost

N/A

N/A

Premium progressive

$95 - $105 Copay

N/A

N/A

Custom progressive

$150 - $175 Copay

N/A

N/A

Average savings of 20-25% on other lens
enhancements

N/A

N/A

Frames

Includes a wide selection of
frames at Walmart

• $200 for the frame of
your choice and 20% off the amount
over your allowance

• $110 allowance at Costco

Up to $70

Once per calendar year

Elective Contact Lenses

Contact lenses are in place
of
lenses and frame

• Up to $60 / 15% savings for your
contact lens exam (fitting and
evaluation)
• $200 for contact lenses

Up to $105

Once per calendar year

Additional Glasses and
Sunglasses Discount

20% off additional glasses and sunglasses, including lens options, from the same VSP doctor on the
same day as your exam. Or get 20% off from any VSP doctor within 12 months of your last exam.

Coverage with Retail
Providers

Coverage with retail providers may be different. Check with Costco and Walmart for VSP member pricing.
The Costco allowance is equivalent to the allowance at preferred providers and other retail providers.

Employee

$7.46

Employee + Spouse

$15.00

Employee + Child(ren)

$13.28

Family

$21.78