Contact Lens Exam Coverage Reminder

As a reminder, a VSP^® contact lens exam benefit is a separate benefit from a VSP WellVision Exam^® benefit. A contact lens exam should only be provided to patients who wear or want to wear contact lenses. As a provider it is your clinical discretion to determine your patient’s specific contact lens prescription and fitting requirements.

What's Covered Under a Contact Lens Exam

VSP’s contact lens exam benefit provides coverage for professional services towards routine contact lens wearing needs; including disposable, conventional, and replacement lenses. When a patient has a copay for their Contact Lens Exam service, the member is covered-in-full for the following:

• Routine, elective (not visually necessary) contact lens exam professional services
• Any fitting and refitting
  • This includes brand and/or modality changes
• Insertion and removal training as necessary

The professional services listed above are covered for 90 days after the initial contact lens exam.

What’s NOT Covered Under a Contact Lens Exam

All professional services for on or off label use for progressive myopia management treatment are not covered under the contact lens exam benefit. This also includes all professional services for lenses associated with Corneal Refractive Therapy (CRT) and Orthokeratology treatment. Professional services not covered by VSP should be handled as a private transaction between you and the patient.

For questions, please contact customer care at 800.615.1883.