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Vision Service Plan has about $2 billion a year in revenue and is purportedly the largest provider in the United States of eyecare coverage.

While plans vary depending on the options selected by the employer, the typical VSP program provides for covering annual eye exams, along with replacement lenses if needs, and bi-annual replacement of frames. Provided the patient uses a provider in the VSP network. selects lenses that are covered by the plan, and selects frames that the provider makes available under the program, the only charge is for a deductible.

Well, there's the rub. Once you go outside of these parameters, your costs can mount up quickly.

rule number 1

If you're limiting yourself to covered lenses, e.g.:

and you want your lenses made of: and you don't care about the frames, then you can go to any participating provider and obtain your eyewear for only the cost of the deductible.

rule number 2

It pays to shop around.

Assuming your eyeglass needs are not met by the above criteria, it pays to shop around, even if you plan to use a participating provider. Here's how you could save money:

If you want continuous bi-focal or tri-focal lenses (i.e. no lines), the charge to you will vary depending on the participating provider.

If you want polycarbonate lensses, a scratch-resistant coating, anti-reflective coating, or photo-sensitive lenses, the charge to you will vary depending on the participating provider.

The selection of covered frames, and the charge to you for frames that aren't fully covered by VSP will vary depending on the participating provider.

If you want additional services, coverage for lost or damaged glasses, additional lenses or frames, this cost will vary depending on the participating provider.

The problem is that shopping for prices from a participating VSP provider may be difficult to do. Go straight to rule number 3.

rule number 3

Most likely, a participating VSP provider won't be your least expensive option anyway.

You'll probably save money by just taking the limited reimbursement that VSP offers and spend that at an out-of-network provider. Let's crunch some numbers:

Assume you need an eye exam, bifocal lenses, and frames. Your VSP plan has a $25 deductible.

You go to your participating VSP provider. You want unlined bifocals and polycarbonate lenses. In addition to the $25 deductible, you might pay $75 for the unlined bifocals and $50 for the polycarbonate lenses. Your out-of-pocket cost is thus $150.

Instead, you get the coupon out of the Sunday newspaper that promises you 50% off the regular retail price at some optical chain that provides both the eye exam and the eyewear. The regular price for the items you select is $400, so your cost is $200.

Here's what VSP might pay under some particular program:

So your net out-of-pocket cost is only $80 instead of $150, so you're $70 ahead and you're not contributing to VSP's deceptive practices.

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Revision r1.2 - 26 Oct 2005 - 21:31 by EliMantel web search for EliMantel
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