Vision
Vision coverage helps with the cost of eyeglasses or contacts. But even if you don’t need vision correction, an annual eye exam checks the health of your eyes and can even detect more serious health issues such as diabetes, high blood pressure, high cholesterol, and thyroid disease. Rakuten International’s vision coverage is offered through Vision Service Plan (VSP).
VSP Vision
Plan Information
Plan Name: VSP Vision
Policy Number: 30078617
Effective Date: 01/01/2025
Provider Network: VSP Vision Care
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Exams
$10 copay
Materials
$25 copay
Single Vision Lenses
No charge after materials copay
Bifocal Lenses
No charge after materials copay
Trifocal Lenses
No charge after materials copay
Frames
Coverage limited to $150 after materials copay
Contacts (in lieu of glasses)
Coverage limited to $130
Frequency
Exams
Every calendar year
Lenses
Every calendar year
Frames
Every calendar year
Contacts
Every calendar year
Out-of-Network Reimbursement
Exams
Up to $45 reimbursement
Materials
Up to $65 reimbursement
Single Vision Lenses
Up to $30 reimbursement
Bifocal Lenses
Up to $50 reimbursement
Trifocal Lenses
Up to $65 reimbursement
Frames
Up to $70 reimbursement
Contacts (in lieu of glasses)
Up to $105 reimbursement
Frequency
Exams
Every calendar year
Lenses
Every calendar year
Frames
Every calendar year
Contacts
Every calendar year