VSP Out-of-Network Reimbursement with Eyebuydirect/Coastal

Summary: I recently purchased glasses online and got reimbursed by my vision insurance with VSP.

Details: I have had vision insurance with VSP through my job for the past 7 years but I never used it. My glasses got scratched recently so I decided to look into getting a new pair of glasses. In the past, I always got my glasses overseas in my home country.

I paid a visit to two stores for eyeglasses and found their prices to be quite high. Even with insurance, a new pair of glasses would be at least $200 due to the necessity of high-index lenses and the addition of basic coatings like anti-reflection. This was much higher than the price quotes I got online from eyebuydirect.com and coastal.com .

I went to a local store to get my eyes checked and my prescription. They included my pupillary distance without any prodding, but I've heard they don't have to give it to you. (You will need this measurement in order to order glasses that will fit your eyes.) I then paid my $10 co-pay with VSP for in-network eye examinations. (This amount will vary according to your plan. I've seen $25 for some VSP plans).

You will need to verify if your vision insurance covers out-of-network providers if you want to buy glasses online. My plan has a $55 allowance for single-vision lenses and $70 for frames. This is subject to the $10 co-pay (my plan is $10 co-pay for exam and/or lenses/frames), but since I already paid the $10 for the exam, there was no other copay.

I bought a pair of glasses on eyebuydirect for about $61 and got reimbursed $55. VSP does not cover the cost of shipping ($5.95). The lenses had an index of 1.6, anti-reflective coating as well as anti-blue coating. I paid $16 out of pocket, whereas the local stores would have charged me $200+.

When ordering, I made sure to choose the packages/bundles so that the various coatings are NOT itemized on the receipt. I do not know if VSP will cover the cost if the coating is on a separate line by itself.

Conclusion : VSP reimburses for purchases from eyebuydirect.com and coastal.com. Make sure you have out-of-network benefits and check the benefit amounts/copays.

edit: Refer to three followup posts (Eyemed + Eyebuydirect, VSP + Eyebuydirect 2019, Filing for Reimbursement 2020).