Vision Benefit

Blue Cross of Idaho contracts with Vision Service Plan (VSP) to provide the vision benefit.

In-Network Vision Benefit

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.

FY24 VSP Vision Contract

FY24 Vision Benefit Summary (No Changes from FY23)

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

Out-of-Network Benefit Feature	FY2023	Limitations
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

Pediatric Vision

(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%. NOTE – Costco and Sam’s Club are not in-network providers for dependents under age 19. If you do use one of those providers for your children, you will only be eligible for the out-of-network reimbursement amount.

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.

NOTE: Retail providers that may be listed under the adult plan MAY NOT be in-network providers for the pediatric plan.

You can use the vision care provider of your choice. The advantage of using a VSP network provider is that VSP network doctors contact VSP to verify your eligibility, plan coverage, and to obtain authorization for services. Upon completion of the appointment, the VSP network doctor submits the claim to VSP for processing and VSP pays the doctor directly.

There are no claim forms to complete when you see a VSP doctor. VSP network doctors contact VSP to verify your eligibility, plan coverage, and to obtain authorization for services. Upon completion of the appointment, the VSP network doctor submits the claim to VSP for processing and VSP pays the doctor directly.

For personal plan information, employees can go to the VSP Web site at: www.vsp.com, and click on the “Register Now” button in the box titled “Already Registered? Log in Here”.

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.

If you choose to see an out-of-network provider rather than a VSP Network Doctor, you will need to submit a claim to VSP for reimbursement.

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.