Blue Cross of Idaho contracts with Vision Service Plan (VSP) to provide the vision benefit.
Starting July 1, 2020 – NEW IN-NETWORK VISION BENEFITS
When you use a VSP provider, you pay a $20 copay for exams and receive a frame allowance of $130. Service frequency limitations apply. If you choose to use an out-of-network provider, you are still eligible for the service reimbursement listed below. Pediatric vision benefits did not change.
Using your VSP benefit.
- Find the right vision provider for you. You can choose to see a VSP doctor or any other provider. Find a VSP doctor near you.
- Review your vision benefit contract if you have any questions about eligible for services and benefit amount.
- At your appointment, tell your doctor you have VSP. There’s no ID card required.
Who is responsible for filing the claim for benefits?
- There are no claim forms to complete when you see a VSP doctor.
- If you choose to go out-of-network and see a provider other than a VSP doctor, you typically have 12 months to submit a claim to VSP for benefit reimbursement.
Adult Out-of-Network Vision Benefit
|Eye Exam||up to $50||one (1) exam every 12 months|
|Frame||up to $50||one (1) frame every 24 months|
|Single Vision lenses, pair||up to $50||one (1) pair every 12 months|
|Bifocal lenses, pair||up to $80||one (1) pair every 12 months|
|Trifocal lenses, pair||up to $95||one (1) pair every 12 months|
|Lenticular lenses, pair||up to $125||one (1) pair every 12 months|
|Elective Contacts, pair||up to $70||one (1) pair every 12 months|
|Medically-necessary Contacts, pair||up to $125||one (1) pair every 12 months|
(under age 19)
Pediatric vision benefits are now covered by the plan at 100% when using a participating provider. Out of network services are covered at 50%.
Per benefit period, Insureds, under age 19, may receive:
One (1) eye exam
One (1) pair of spectacle Lenses or Contact Lenses
One (1) Frame (selection may be limited by provider)
For more information about your pediatric vision benefit, review the PEDIATRIC VISION CARE BENEFIT provisions in each of the medical plan contracts posted on the OGI Medical webpage.
Vision and the High Deductible Plan
For services prior year services, from 7/1/2019 – 6/30/2020, members must submit a completed State of Idaho Vision Deductible Credit Request, if you are enrolled in the High Deductible Health Plan (HDHP). This form allows Blue Cross of Idaho to properly apply your out-of-pocket vision expenses to your deductible accrual.
For the HDHP, except for preventive services and medications, medical, pharmacy and vision are subject to the deductible before the plan begins to pay. You can review the full plan contract posted on the OGI Medical page for more detail.
On the next screen, click the “Member Registration” area. You will be asked to provide a member/employee ID (Your social security number will not work), along with first and last name and birth date. The member ID is the same as your Enrollee Identification Number on the Blue Cross card, excluding the alpha characters.
Entering that information will take employees to a standard registration page that requests an account name and choice of a password. The user name cannot contain any special characters or spaces and the password must contain a numeral.
Anyone who experiences problems completing the registration process or who forgets his/her password can contact VSP for assistance at (800) 877-7195.
Visit the Benefits & Claims section of the VSP website to submit a claim. You’ll have the opportunity to upload receipts or submit them by mail. Please submit your itemized receipt(s) along with the out-of-network reimbursement form. VSP will reimburse you the allotted amount based on your benefits.