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Value added programs SM Diabetic Eyecare Plus Program Included Diabetic exam reminder letters Included Health-focused care Included Hearing aid discounts Included Low vision Included Out-of-network allowances Bifocal lenses, up to $50 Elective contact lens materials and fitting/evaluation, up to $105 Examination, up to $45 Frame, up to $70 Lenticular lenses, up to $100 Single vision lenses, up to $30 Trifocal lenses, up to $65 Extra discounts & savings 5 Additional pairs of glasses 20% savings Laser vision correction (LVC) Average 15% Discount Average savings of 30% on other lens Lens enhancements enhancements 5 20% savings on unlimited additional pairs of prescription or non-prescription glasses/sunglasses, including lens enhancements, from a VSP provider within 12 months of your last WellVision Exam®. VSP QUESTIONS? VSP OUT-OF-NETWORK REIMBURSEMENT CLAIMS (800) 877 7195 PO Box 495918, Cincinnati, OH 45249-5918 BM-SOB-0036-202306

Vision Benefits Summary   VSP Choice Plan 6 - Page 2 Vision Benefits Summary VSP Choice Plan 6 Page 1 Page 3