In-Network | Out-of-Network | |
Well Vision Exams | Plan pays 100% after $10 copay | Plan pays up to $50 after $10 copay |
Primary and Diabetic Eye Care Services | $20 copay | Not covered |
Retinal Screening (per screening, once per year) |
$10 copay | Not covered |
Lenses and Frames Copayment | $25 copay | See limits below |
Contact Lens Copay | $25 copay | See limits below |
Lenses & Frames (once every calendar year) | ||
Single Vision Lenses | Plan pays 100% | Plan pays up to $50 |
Bifocal and Trifocal Lenses (lined) | Plan pays 100% | Plan pays up to $75 and $100 |
Standard Progressive Lenses | Plan pays 100% | Plan pays up to $75 |
Anti-Reflective Coating | $30 copay | Not covered |
Adult and Child Polycarbonate Lenses | Plan pays 100% | Not covered |
Non-Prescription Sunglass Lenses | Plan pays 100% | Not covered |
Blue-Light-Filtering Lenses | Plan pays 100% | Not covered |
Frames | Plan pays up to $200, plus 20% off any out-of-pocket cost Play pays up to $110 at Costco |
Plan pays up to $70 |
Contact Lenses (in lieu of lenses and frames) | ||
Elective | $60 copay for fitting Plan pays $200 for contacts |
$60 copay for fitting Plan pays up to $105 for contacts |
Necessary | Plan pays 100% | Plan pays up to $210 |
Laser Vision Correction LASIK, Custom LASIK, or PRK |
Plan pays up to $1,000 per eye | Not covered |
BUY-UP Plan | ||
Frames or Contacts | Same allowance for second pair of glasses or contact lens | Same allowance for second pair of glasses or contacts |
*This overview summarizes the Marvell Benefits Program. Full details of the benefit plan are contained in the official documents, which will govern in the case of any discrepancies.
- A look at your VSP Vision Coverage
- View network comparison here.