Notice

Happy Thanksgiving! Our offices will be operating during normal call center hours from 8:00 AM to 5:00 PM ET on Wednesday, November 27th. We will be closed on Thursday, November 28th and Friday, November 29th to allow our associates time to spend with their families and loved ones. We wish you a wonderful holiday filled with gratitude and joy!


We apologize for any inconvenience this may cause. Please self-service by signing into your account or using our Interactive Voice Response System (IVR) 24/7 at 800-452-9310.

DeltaVision® plan comparison


 
  DeltaVision - Essential DeltaVision - Brilliance DeltaVision - Premium DeltaVision - Platinum
Exam/lens/frame frequency (months) 12/12/24 12/12/12 12/12/12 12/12/12
Contacts
(in lieu of glasses)
12 12 12 12
In-network coverage
Exam copay $10 $10 $0 $0
Materials copay $25 $10 $0 $0
Frame allowance $130 - Includes Walmart & Sam's Club*
$70 - Costco* frame allowance
$150 - Includes Walmart/Sam's Club*
$80 - Costco* frame allowance
$175 - Includes Walmart/Sam's Club*
$95 - Costco* frame allowance
$200 - Includes Walmart/Sam's Club*
$110 - Costco* frame allowance
Elective contact lens allowance $130 $150 $175 $200
Necessary contact lenses Covered in full after copay Covered in full after copay Covered in full Covered in full
Contact lens fit/ eval copayment $60 $60 $60 $60
Both frames and contacts in same year (in-network and out-of-network) No; allows contacts in lieu of frames No; allows contacts in lieu of frames No; allows contacts in lieu of frames Yes; allows both frames & contacts in the same year for each benefit



All DeltaVision plans have the below Lens Enhancement benefits, Out-of-Network Allowances, and Additional Savings benefits.

Lens Enhancements1


Benefits Costs your plan covers
Anti-glare Coating $41 Single
$41 multifocal
Impact-resistant Lenses $31 Single
$35 multifocal (covered for children)
Progressive Lenses Standard progressive lenses are covered
Light-reactive Lenses $75 single vision
$75 multifocal
Scratch-resistant Coating $17 single vision
$17 multifocal



Out-of-Network Allowances (in addition to in-network copays)


Benefits Covered up to
Examination $45
Single Vision Lenses $30
Bifocal Lenses $50
Trifocal Lenses $65
Progressive Lenses $50
Lenticular Lenses $100
Frame $70
Elective Contact Lenses $105
Necessary Contact Lenses $210



Additional Savings


Benefits Plan Details
Frames discount over allowance2 There is an extra $20 allowance on featured designer brands for frames.
20% savings on any amount above the retail allowance.
Additional Pair2 20% savings on unlimited additional pairs of prescription glasses and/or nonprescription sunglasses from any VSP provider within 12 months of exam.
Lasik2 Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities.
Retinal screening2 Routine retinal screening covered at no more than $39 copay.
Lens Coverage2 Glass or plastic single vision, lined bifocal, lined trifocal, or lenticular lenses are covered in full.3
Essential Medical Eye Care
  • Retinal screening for members with diabetes covered-in-full.
  • Additional exams and services beyond routine care to treat immediate issues such as pink eye or to monitor ongoing conditions like high blood pressure, diabetes, and more. Coordination with your medical coverage may apply. Ask your VSP network doctor for details. Available as needed. $20 per exam.
  • Low Vision
  • Pre-approved low vision supplemental testing covered every two years.
  • 75% coverage for approved low vision aids, up to $1,000 (less any amount paid for supplemental testing) every two years.
  • Eyeconic® 2 Visit Eyeconic.com for an easy-to-use, convenient online eyewear option.
    TruHearing® 4 Save up to 60% on hearing aids and batteries. Visit TruHearing.com/VSP or call 877-396-7194 for more information.




    Disclaimers and Exclusions

    Promotions and Featured Frame Brands do not apply at Costco® Optical, Walmart, Sam’s Club, and other participating retail chains.
    *In-network status of the optometrist performing the exam may vary at participating retail chains. Please contact VSP and/or the optometrist at the retail location to verify network participation status before receiving services.

    1Prices shown reflect the standard plastic price for each respective category. Premium lens enhancement prices may vary. Prices are valid only through VSP Choice Network Providers and are subject to change without notice.

    2Available in-network only.

    3Covered in full materials and services are less any applicable copay. Based on applicable laws, benefits and savings may vary by location. Benefits may also vary at participating retail chains. Promotions like rebates are continually evaluated and subject to change without notice. In the state of Washington, VSP Vision Care, Inc. is the legal name of the corporation through which VSP does business.

    The following items are excluded under this plan: plano lenses (lenses with refractive correction of less than +/-. diopter), two pairs of glasses instead of bifocals; replacement of lenses, frames, or contacts; medical or surgical treatment; orthoptics; vision training or supplemental testing.

    4VSP is providing information to its members, but does not offer or provide any discount hearing program. VSP makes no endorsement, representations or warranties regarding any products or services offered by TruHearing, a third-party vendor. TruHearing is not insurance and not subject to state insurance regulations. For additional information, please visit vsp.com/offers/special-offers/hearing-aids/truhearing. For questions, contact TruHearing directly. Not available directly from VSP in the states of Washington and California.

    This overview contains a general description of your vision care program for your use as a convenient reference. Complete details of your program appear in the group contract between your plan sponsor and Delta Dental of Connecticut, Inc., which governs the benefits and operation of your program. The group contract would control if there should be any inconsistency or difference between its provisions and the information in this overview. Claims processing, claims service, and provider network administration for DeltaVision are provided under contract by VSP. VSP, Eyeconic, and eyeconic.com are registered trademarks of Vision Service Plan.