2024 vision plan comparison
The Provider Network for both vision plans is the VSP Network, including VSP-participating locations.
| Basic | High | |
|---|---|---|
| Your weekly cost | Participant Only: $0 (Non-HI and HI) Participant + Spouse/DP: $1.60 (Non-HI)/ $0 (HI) Participant + Child(ren): $1.60 (Non-HI)/ $0 (HI) Participant + Family: $2.60 (Non-HI)/ $0 (HI) |
Participant Only: $3.80 Participant + Spouse/DP: $6.80 Participant + Child(ren): $6.80 Participant + Family: $10.50 |
| Eye exams | In-network: Plan pays 100% Out-of-network: Plan pays up to $19 |
In-network: Plan pays 100% Out-of-network: Plan pays up to $19 |
| Lenses | In-network: $40 copay Out-of-network: Limited coverage |
In-network: $10 copay Out-of-network: Limited coverage |
| Frames | In-network: Plan pays up to $130 plus 20% discount on amount above $130, every other calendar year Out-of-network: Plan pays up to $22 |
In-network: Plan pays up to $155 plus 20% discount on amount above $155, once per calendar year Out-of-network: Plan pays up to $22 |
| Contact lenses | In-network: $40 copay for exam; plan pays up to $130 for contact lenses every other calendar year Out-of-network: Plan pays up to $130 every other calendar year |
In-network: $10 copay for exam; plan pays up to $155 for contact lenses once per calendar year Out-of-network: Plan pays up to $130 once per calendar year |
| Computer vision care | Not covered |
Lenses: $10 copay once per calendar year Frames: Plan pays up to $90 every other calendar year |