LOW VISION Professional services for severe visual problems that cannot be corrected with regular lenses, including: Supplemental Testing: Up to $125.00*. -Includes evaluation, diagnosis and prescription of vision aids where indicated. Supplemental Aids: 75% of VSP Open Access Provider’s fee, up to $1000.00* *Maximum benefit for all Low Vision services and materials is $1000.00 every two (2) years and a maximum of two supplemental tests within a two-year period. Low Vision Services are a Plan Benefit when specific benefit criteria are satisfied and when prescribed by Covered Person's Doctor. EXCLUSIONS AND LIMITATIONS OF BENEFITS 1. Exclusions and limitations of benefits described above for VSP Network Providers shall also apply to services rendered by Open Access Providers. 2. Services from an Open Access Provider are in lieu of services from a VSP Network Provider. 3. There is no guarantee that the amount reimbursed will be sufficient to pay the cost of services or materials in full. 4. VSP is unable to require Open Access Providers to adhere to VSP’s quality standards. 17
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