Vision
Your vision benefits are provided by Vision Service Plan (VSP).
How to use your benefits:
- Call your VSP doctor and make an appointment.
- When you call, tell the doctor you are a VSP member and give the following information:
- Your name and date of birth
- The name of the group that provides your VSP coverage (Operating Engineers)
- Covered member's VSP identification number (usually the Social Security number)*
*The covered member is the person whose group provides your VSP coverage. If it's not your group that provides you with VSP, then it's probably your spouse or a parent.
- After you make an appointment, your doctor and VSP will handle the rest. The doctor will check your eligibility for services and plan coverage.
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Maximum Calendar Year Benefit
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No overall calendar-year limit
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Copayment
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$7.50 per individual, payable for the first service rendered each year
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Item
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VSP Provider
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Non-VSP Provider
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Exam (once every 12 months)
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Covered in full
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Plan reimburses up to $37
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Frames (once every 24 months)
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Covered up to Plan allowances
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Plan reimburses up to $40
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Eyeglass Lenses (once every 12 months when warranted by prescription change)
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· Single Vision
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Covered in full
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Plan reimburses up to $34 per pair
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· Bifocal
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Covered in full
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Plan reimburses up to $51 per pair
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· Trifocal
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Covered in full
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Plan reimburses up to $68 per pair
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· Lenticular
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Covered in full
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Plan reimburses up to $100 per pair
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Contact Lenses (once every 12 months)
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· Visually necessary
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Plan pays 75% of cost (with prior approval from VSP)
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Plan reimburses up to $126 for professional fees and materials
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· Elective
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Professional fees and materials covered up to $100
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Plan reimburses up to $100 for professional fees and materials
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Low Vision Benefit
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Maximum Benefit
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$500 (after copayment) every two (2) years
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Copayment
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50% of VSP provider charges for supplemental aids
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Item
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VSP Provider
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Non-VSP Provider
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Supplemental Testing
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Covered in full
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Plan reimburses up to $125
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Supplemental Care Aids
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Plan covers 50% of cost
Subsequent low vision aid as visually necessary or appropriate
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Plan reimburses up to 50% of what VSP provider would charge
Subsequent low vision aid as visually necessary or appropriate
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The following summary is intended only as a general description of Plan benefits. For a complete description of benefits and Plan exclusions and limitations, please refer to the Kaiser "Evidence of Coverage.
Vision Benefit
$5 co-pay per visit; $150 allowance for eyeglasses purchased from Plan optical sales office, every 24 months.
The following summary is intended only as a general description of Plan benefits. For a complete description of benefits and Plan exclusions and limitations, please refer to the Health Net "Evidence of Coverage.
Vision Benefit $5 co-pay for exam; no charge for standard eyeglass lenses, available every 24 months or every 12 months if prescription change; $100 frame allowance every 24 months (member pays 80% of remaining balance).
Contact Lenses – in lieu of glasses
Conventional/Cosmetic: (one pair every 24 months) – Health Net Vision pays the first $100, and member pays 85% of remaining balance. Disposable/Cosmetic: (You need to purchase enough pairs to reach the allowable amount at one visit. If you do not use the full $100 allowed amount during the initial purchase, the remaining balance will not carry over.) – Health Net Vision pays the first $100, and member pays the remaining balance
Medically necessary: (one pair every 24 months) – Health Net Vision pays the first $250, and member pays the remaining balance
The following summary is intended only as a general description of Plan benefits. For a complete description of benefits and Plan exclusions and limitations, please refer to the Plan's Benefits Summary and "Evidence of Coverage".
Vision Benefit
$15 co-pay for exam, every 12 months; Materials not covered.
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