COVERED SERVICES AND MATERIALS EYE EXAMINATION- Covered in full* once every 12 months** Comprehensive examination of visual functions and prescription of corrective eyewear. LENSES - Covered in full* once every 12 months** Lenses (Single, Lined Bifocal, Lined Trifocal or Lenticular) Polycarbonate lenses are covered in full for dependent children up to the end of the month in which they turn age 26. Standard Progressive Lenses covered in full. FRAMES - Covered up to the Plan allowance* once every 24 months** The VSP NETWORK Provider will prescribe and order Covered Person’s lenses, verify the accuracy of finished lenses, and assist Covered Person with frame selection and adjustment. Frame allowance may be applied towards non-prescription sunglasses or blue light filtering glasses, exhausting both frame and lens eligibility. Lab fabricated plano lenses are not covered. CONTACT LENSES ELECTIVE The Elective Contact Lens fitting and evaluation services are covered in full once every 12 months, after a $60.00 Copayment. Elective Contact Lenses (materials only) are covered up to $150.00 once every 12 months** NECESSARY Necessary Contact Lenses are covered in full* once every 12 months** Necessary Contact Lenses are a Plan Benefit when specific benefit criteria are satisfied and when prescribed by Covered Person's VSP Network Provider. Contact Lenses are provided in place of spectacle lens and frame benefits available herein. *Less any applicable Copayment. **beginning with the first day of the Benefit Period. 7