VSP Vision Care Plans Update
Vision care providers are opening up for routine eye appointments with some changes to network participation, appointment availability and other business practices to accommodate new operational norms and safety standards. As a result, members may want more flexibility in choosing providers who have appointment availability and preferred geographic locations, regardless of network status. Additionally, members may be concerned if a provider changes network status to “non-participating” or “OON” and the effect on out-of-pocket expenses for eye exams under the City’s vision care plans.
To help with network and cost changes that may occur, VSP has increased the out-of-network eye exam allowance under the City’s Vision Care Plans from $45 to $70 (after $10 copay), effective July 1, 2020. An example of how this could be beneficial to members is Oasis Eye Care – Dr Alicia McCallan, an independent vision provider located within the Costco store on Sossaman Rd in Mesa. This vision care provider suspended all network participation for eye exam services April 1, 2020. Costco Optical remains in-network for VSP with specific allowances on frames, lenses and contacts etc. However, as has always been the case, independent eye exam services in many Costco locations may or may not be in-network with VSP. Even if a provider is located in Costco and was in-network in the past, some may not be re-opening as an in-network provider, until further notice. Check with your provider directly to confirm their ongoing network participation. If you want to continue to use a provider on an out-of-network basis, you will need to file a vision care claim directly with VSP to receive your OON benefit.
How to file an OON claim for eye exam services with VSP:
- Pay the OON provider at time of service and,
- Get an itemized bill for the services (what, when, for whom and how much) and,
- Submit a claim to VSP for direct reimbursement up to the new $70 out-of-network eye exam allowance (minus $10 copay) - if the services are provided on or after July 1, 2020
- Online claims filing: go to www.vsp.com, complete OON claims form provided, upload documentation and submit claim, or,
- Mail completed, paper claim form and copy of itemized bill to:
- VSP, PO Box 385018, Birmingham, AL 35238-5018