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Your VSP Vision Benefits Summary: Frequency Copay Description Benefit
Your VSP Vision Benefits Summary: Frequency Copay Description Benefit
UNIVERSITY HEALTH PLANS and VSP provide you with an affordable eyecare plan.
VSP Coverage Effective Date: 09/01/2020
VSP 9bfc``aYbh8YUX`]bY: 08/15/2020
` VSP Provider Network: VSP Choice
Benefit Description Copay Frequency
Your Coverage with a VSP Provider
WellVision Exam Focuses on your eyes and overall wellness $10 Once every 12 months
Contacts (instead of $150 allowance for contacts; copay does not apply
Up to $60 Once every 12 months
glasses) Contact lens exam (fitting and evaluation)
Eligibility
-Enrollee
-Legal Spouse of Enrollee
-Domestic Partner of Enrollee
-Unmarried dependent up to age19 or age 26 if a full-time student