Vision Care Benefits

The RIT Vision Care Plan is designed to cover much of the cost of prescription eyeglasses and contact lenses through a fully-insured plan administered by VSP.

General Information

Regular full-time and part-time employees scheduled to work nine or more months are eligible to participate in the plan 12 months per year; regular full-time and part-time employees scheduled to work less than nine months are eligible to participate in the plan when working at RIT.

Employees may cover their spouse/domestic partner and children up to age 26. Vision coverage is fully paid by employee payroll deductions.

If you elect coverage as new hire, coverage begins on the first day of the month on or after your date of employment. You need to enroll during your initial new hire enrollment period, during a mid-year qualifying event where you lost Vision Care coverage or during an annual Open Enrollment period. If you enroll during an Open Enrollment period, your coverage will be effective on January 1 of the upcoming year. 

You can find participating providers at VSP Vision Care or by calling VSP at (800) 877-7195/v and (800) 428-4833/TTY Monday – Friday 8 a.m. to 10 p.m., Eastern Time.

Note: RIT’s medical coverage under POS A, POS B, POS B No Drug, and POS D covers routine eye exams with a copay. If you want to continue using your same eye doctor who is not a VSP provider, use your medical ID card at the eye doctor. Then you can take your prescription for eyeglasses or contacts to a VSP provider.

If you or a covered family member receives coverage from a non-VSP provider, you should pay the provider’s full fee at the time of service and then submit an itemized bill to VSP for reimbursement according to the schedule of allowances. Discounts do not apply for vision care benefits obtained from non-VSP Providers, so your cost is likely to be higher if you receive services from a non-VSP Provider.

You can enroll in the RIT Vision Care Plan whether or not you have RIT medical coverage – they are two separate enrollments; you can have the Vision Care Plan without having RIT’s medical coverage.

You can set up an member account on the VSP website to manage your coverage. Click on Members then Member Log In to log in or create an account. Enter your University ID number (UID) for the Member ID along with the other required information. 

Once your account is set up, you will be able to see information about your coverage. From your account, you will also be able to print a Member ID Card to keep in your wallet; the card does not have the VSP ID on it.

Plan Details

Vision coverage is offered through VSP. Well vision exams have a $15 copay and there is a $150 allowance for frames or contacts each calendar year.

Member will receive the below in-network benefits when they go to a participating provider.

 Service Coverage Information
Eye Exam

A routine eye exam is covered once per calendar year with a $15 copay.

A diabetic eye exam has a $20 copay (see details below about the VSP Diabetic Eyecare Plus ProgramSM.

Lenses

VSP’s standard lenses are covered in full, every calendar year, after a $20 copay, including glass or plastic single vision, bifocal, trifocal, progressive, or other more complex lenses necessary for the patient’s visual welfare.

There is an additional cost for various coatings (e.g., anti-reflective, scratch, etc.), but VSP does provide a discount on these optional items.

Frames $150 allowance toward frames, every calendar year. If you select a frame that costs more than $150, VSP offers a 20% discount off the amount over the retail allowance. Some frames qualify for a $170 featured frame brands allowance.
Contact Lenses You may choose contacts instead of glasses (lenses and frame). There is a $150 allowance applied to the contact lens exam (fitting & evaluation) and the contact lenses. You also receive a 15% discount off the contact lens exam before the allowance is applied. 

 

Note: RIT’s medical coverage under POS A, POS B, POS B No Drug, and POS D covers routine eye exams with a copay. If you want to continue using your same eye doctor who is not a VSP provider, use your medical ID card at the eye doctor. Then you can take your prescription for eyeglasses or contacts to a VSP provider.

The VSP Diabetic Eyecare Plus ProgramSM provides coverage of additional eyecare services specifically for members with diabetic eye disease, glaucoma or age-related macular degeneration (AMD). Eligible members can receive both routine and follow-up medical eyecare from their VSP doctor—the doctor who already knows their eyes best. A summary of the coverage is as follows:

  • The VSP Diabetic Eyecare Plus ProgramSM provides coverage of additional eyecare services specifically for members with diabetic eye disease, glaucoma or AMD, including:
    • medical follow-up exams,
    • visual field and acuity tests,
    • specialized screenings and diagnostic tests,
    • diagnostic imaging of the retina and optic nerve,
    • retinal screening for eligible members with diabetes.
  • The program also provides supplemental1 coverage for non-surgical medical eye conditions such as diabetic retinopathy, abnormal blood vessel growth on the eye (rubeosis), and diabetic macular edema.
  • Members can self-refer2, visit their VSP Provider as often as needed, and pay only a copay for services.

1 The VSP Diabetic Eyecare Plus Program pays secondary to other medical eye insurance coverage.
2 Unless referral by a primary care physician is required by the health plan.

Low Vision Services are a plan benefit when specific benefit criteria are satisfied and when prescribed by the covered person’s VSP Preferred Provider. Professional services for severe visual problems not correctable with regular lenses are covered as follows:

  • Supplemental Test: Covered in full*
  • Supplemental Aids: 75% of VSP Preferred Provider’s fee, up to $1,000*

*maximum benefit for all Low Vision services and materials is $1,000 every two (2) years and a maximum of two supplemental tests within a two-year period.

Some brands of spectacle frames may be unavailable for purchase as Plan Benefits, or may be subject to additional limitations. You may obtain details regarding frame availability from the VSP Member Doctor or by calling VSP’s Customer Care Division at (800) 877-7195.

This Plan is designed to cover visual needs rather than cosmetic materials. If you or a covered family member selects any of the following extras, the Plan will pay the basic cost of the allowed lenses, and you will pay the additional costs for the options.

  • Optional cosmetic processes
  • Anti-reflective coating
  • Color coating
  • Mirror coating
  • Scratch coating
  • Cosmetic lenses
  • Laminated lenses
  • Oversize lenses
  • Photochromic lenses, tinted lenses except Pink #1 and Pink #2
  • UV (ultraviolet) protected lenses
  • Certain limitations on low vision care

Not Covered
There are no benefits for professional services or materials connected with:

  • Orthoptics or vision training and any associated supplemental testing
  • Plano lenses (less than a ±.50 diopter power)
  • Two pair of glasses in lieu of bifocals
  • Replacement of lenses and frames furnished under this plan that are lost or broken, except at the normal intervals when services are otherwise available
  • Replacement of lost or damaged contact lenses, except at the normal intervals when services are otherwise available.
  • Medical or surgical treatment of the eyes
  • Local, state and/or federal taxes, except where VSP is required by law to pay
  • Services associated with Corneal Refractive Therapy (CRT) or Orthokeratology
  • Corrective vision treatment of an experimental nature, unless approved by an external appeal agent
  • Plano contact lenses to change eye color cosmetically
  • Artistically-painted contact lenses
  • Contact lens insurance policies or service contracts
  • Additional office visits associated with contact lens pathology
  • Contact lens modification, polishing, or cleaning
  • Costs for services and/or materials above Plan Benefit allowances
  • Services or materials of a cosmetic nature
  • Services and/or materials not indicated on this Schedule as covered Plan Benefits

Liability in Event of Non-Payment
In the event VSP fails to pay a VSP preferred provider, you will not be held liable for any sums owed by VSP other than those not covered by the plan.

You can print a Member ID card from the VSP website. You will not receive an ID card from VSP. And, when you go to a VSP provider, you simply let them know you are a VSP member and they will take care of the rest (no claim forms to file). The ID number will be your RIT University ID (UID) number.