|Eye Exam (not including contact exam)||$15 Copay||Reimbursed up to $45|
|Frames||100% covered, $170 Benefit Max||Reimbursed up to $70|
|Single Vision||$35 Copay||Reimbursed up to $30|
|Bifocal Lined||$35 Copay||Reimbursed up to $50|
|Trifocal Lined||$35 Copay||Reimbursed up to $65|
|Anti-Reflective Coating||100% Covered||Not Covered|
|Blended Lenses||100% Covered||Reimbursed up to $50|
|Progressive Lenses||100% Covered||Reimbursed up to $50|
|Tinted/Photochromic||100% Covered||Not Covered|
(instead of frames and lenses)
|100% Covered, $170 Benefit Max||Reimbursed up to $105|
|Contact Lens Exam||Up to $60 copay||Not Covered|
The exam, frames and lenses are available every 12 months, starting wiith the first date of service.
An ID card isn’t required to receive services. Simply call a VSP provider to schedule an appoinment and tell them you are a VSP member. The provider and VSP will handle the rest. If you would like an ID card, log on to VSP.com or the VSP app to access.
The information on this page is a partial description of benefits, limitations, exclusions, and other provisions of the group benefits provided by Woodmen of the World Life Insurance Society (WoodmenLife). If there is a difference between the information in this summary and the plan document for each plan, the plan documents govern. Eligibility requirements apply to each of the benefits offered, criteria may include employment status and/or individual qualifications. For more detailed information, refer to the Summary Plan Description of each plan. WoodmenLife may amend these plans at any time. The description of the plan is not a guarantee of benefits and should not be construed as such.
This is the Life is a registered service mark of Woodmen of the World Life Insurance Society.