When it comes to vision insurance, the terminology can be puzzling—yet understanding these words is the fastest way to unlock the full benefits vision insurance can provide. A solid grasp of the common phrases will help you estimate eye care expenses, compare the cost of vision insurance plans, and ultimately choose the best insurance plan for your unique vision health needs.
Many people are left scratching their heads with questions like, “What’s a copay?” or “What does the allowance apply to?” Below are vision insurance terms you’ll see while exploring VSP® vision plans, along with additional tips to help you explore vision insurance options, understand what vision insurance typically covers and maximize the value of your plan.
Individual Vision Plan Versus Employer-Sponsored Plans
A VSP Individual Vision Plan is vision insurance you buy on your own directly from VSP. An employer-sponsored vision plan is one you enroll in through an employer, and it often comes bundled with other health insurance policy options. Understanding the differences between these plans can help you select the vision insurance that aligns with your budget, location, and lifestyle. This type of plan is perfect for freelancers, retirees, or anyone whose employer doesn’t offer covered health insurance that includes routine eye care services.
Glasses Frame Allowance
Your in-network frame allowance is the amount VSP will cover for your frames or for lens enhancements. For frames, a typical allowance is $150. In that case, if you choose frames that cost less than $150, you pay nothing. By understanding this frame allowance, you can better manage care expenses and still enjoy stylish prescription eyewear without breaking the bank. Remember: If your vision insurance renews yearly, you can usually revisit your allowance during each coverage period to refresh your eyewear style. If you choose frames that cost more than $150, you’ll pay the difference. So, for frames that cost $170, you’ll get a 20% discount on the amount over your allowance at the doctor’s office—about $18. VSP members can also get an Extra $20 to spend on Featured Frame Brands*. So if you choose a $170 frame that is a Featured Frame Brand—your additional cost could be $0.
Vision Insurance Copay
This is the fixed amount paid by you to the doctor’s office when you visit a VSP network doctor. Because routine eye exams are the foundation of good vision health and early detection of eye conditions, knowing your copay cost up front helps you budget for routine eye care with confidence.
Take an eye exam for example: Once you pay the exam copay to your VSP network doctor, your plan will pay your doctor an agreed upon fee for your eye exam. For most VSP Individual Vision Plans, the copay is only $15 for a comprehensive eye exam and $25 for glasses. Copays are due to the doctor’s office at the time you receive the service.
Out-of-Pocket Cost
This is the total amount you pay for your vision care, including the cost of your vision plan (your premium), plus the costs you pay at the doctor’s office. Out-of-pocket amounts can include copays, upgrades, and any eye care expenses for services or materials that your vision insurance coverage does not fully reimburse. Tracking these expenses helps you evaluate the overall cost vision insurance represents in your household budget.
Vision Insurance Premium
This is the amount you pay to VSP for your vision plan. There are two options for payment:
-
Annual payment: Your premium is paid in full at the time of purchase.
-
Monthly installments: Your annual premium is split into 12 monthly payments, making it easier to manage cash flow and spread care expenses evenly throughout the year. When comparing plans that vision insurance carriers offer, keep an eye on the premium, any included vision benefits, and what’s required from you before the insurance coverage kicks in.
In-Network and Out-of-Network Vision Care Providers
-
In-network doctors are part of the VSP doctor network. Because our network is vast, you’ll almost certainly find an in-network doctor who’s right for you. In-network access often means lower eye care expenses because the insurance vision contract has pre-negotiated rates.
-
Out-of-network doctors are not part of the VSP network. They may see VSP members or say, “We accept VSP”, but if they’re not part of the VSP doctor network, your benefits will likely be significantly less.
To ensure your eye doctor is in-network, visit the VSP Find a Doctor page and enter your ZIP code to find one in your area. If you’d like to visit an out-of-network doctor, give VSP a call before your appointment to understand how your benefits will be impacted and what portion of your vision care expenses you may need to pay up front.
Open Enrollment
This applies only to employer-sponsored plans and is the yearly period, typically a couple of months, when you can enroll in insurance plans through an employer. With VSP Individual Vision Plans, there is no open enrollment period. You can enroll anytime and choose your coverage start date. This flexibility allows you to secure vision insurance coverage when you need it most, rather than waiting for a specific season. You have the option to enroll and use your benefits the same day—there’s no waiting period!
Glasses Lens Enhancement or Lens Option
A lens enhancement or lens option is an elective feature for your prescription lenses designed to improve your overall experience with your glasses. They often improve your vision and/or comfort, and knowing what vision insurance coverage includes for these upgrades will help you decide whether to add them. Here’s a list of some common lens enhancements:
-
Scratch-resistant coatings: Reduces normal scratching and pitting on plastic lenses, potentially extending the life of your prescription eyewear.
-
Impact-resistant lenses, also referred to as polycarbonate: A lens material that is impact and scratch resistant, light, thin, and gives UV protection.
-
Anti-glare coating, also referred to as anti-reflective coating: Combats eyestrain from glare and reflections. Protects lenses from scratches.
-
No-line multifocal, also referred to as progressive lenses: Lenses with multiple prescription zones for near, midrange, and long-range vision and no visible line separating these zones as you would see on a bifocal.
Vision Coverage Benefits
These are general terms referring to what services and materials are included in your vision plan. The benefits included for most VSP Individual Vision Plans are a comprehensive eye exam, and glasses or contacts.
Health Savings Account (HSA)
This is a savings account used in combination with a high-deductible health insurance policy that allows users to save money tax-free and use it toward medical expenses. HSA funds can often be applied to eye care services, prescription eyewear, contact lenses, and even LASIK, helping you offset eye care expenses that your insurance may not fully cover.
1-Person Plan, 2-Person Plan, and Family Vision Plans
Depending on the needs of your household, this is where you’ll decide who’s covered on your VSP Individual Vision Plan. If it’s just you, you’ll select a 1-person plan. If it’s you and a spouse, you’ll select a 2-person plan. If it’s you, a spouse, and one more dependents (up to age 26), you’ll select the Family Plan. Choosing the correct coverage level ensures that everyone in your family receives the vision health support they need, from kids’ routine eye care to adult prescription eyewear updates.
Enroll in a Vision Plan
This is the action you take to sign up for a VSP Individual Vision Plan. There is no open enrollment period for VSP Individual Vision Plans. You can sign up anytime to become a VSP member.
Once you finish the online application and your payment is processed, you’re officially a VSP member. Your benefits can be effective the same day. This quick turnaround means you can schedule routine eye exams or purchase glasses without delay, helping you manage vision care expenses promptly.
If you have more questions and want to talk to a representative about VSP Individual Vision Plans, we’re here to make vision insurance as simple as possible for you: You can give our knowledgeable customer service representatives a call at 800.785.0699 or learn more about vision benefits, savings, and coverage today. By taking a few minutes to explore vision insurance options, you’ll discover how an affordable vision insurance plan can protect your eyes, your wallet, and your future vision health.
Information received through VSP Individual Vision Plans’ social media channels is for informational purposes only and does not constitute medical advice, medical recommendations, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
*Frame brands and offer subject to change. Only available to VSP members with applicable plan benefits. Only available at in-network locations.
Your vision. Your way.
Not covered for vision? Get an individual plan, customized for you – including where you want to use it: at the doctor, in a retail location, or even online.
Your Complete Guide to Vision Insurance Basics
Your vision health is important. One of the best investments you can make in your long-term vision health is adding vision insurance to your health ...
Where to Buy Glasses: Online vs. In-Store
Article Medically Reviewed by Dr. Valerie Sheety-Pilon Buying new glasses isn’t just about picking a style you like, it’s also about ho...
Dental & Vision Insurance for Entrepreneurs
Article Medically Reviewed by Dr. Valerie Sheety-Pilon Being a self-employed entrepreneur has unique insurance needs, so what is an entrepreneur? P...
