The difference between an in-network and out-of-network eye doctor

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Whether you already have a great relationship with your eye doctor or are looking to get an eye exam for the first time, it’s easy to find a VSP network eye doctor who’s right for you on vsp.com. To help you get the most out of your benefits, let’s break down the difference between in-network and out-of-network locations.

What makes an eye doctor in-network?

In-network eye doctors have a contractual agreement with VSP to provide you with high-quality eyecare in exchange for pre-negotiated savings on the services and goods they provide, like your eye exam, glasses and contacts. That helps give you the standard of care you expect from VSP for a reasonable price.

in-network

Be part of the “in” crowd

Your benefits will always go further when you visit one of our more than 37,000 in-network eye doctors versus an out-of-network provider. You’ll save more on the essentials you care most about, like an eye exam, frames and lens enhancements.

When you see an out-of-network provider, they have more flexibility for how much they can charge for their services. That typically means you’ll pay a higher out-of-pocket cost overall. You also usually have to pay for these costs up front and then manually submit a claim for reimbursement for any out-of-network coverage your plan allows.

Insider Tip: Save even more with exclusive offers available only from VSP network eye doctors who participate in the Premier Program.

Be mindful of places that “accept” VSP

Most VSP members choose to use their benefits in-network to save the most money. However, some out-of-network retail locations and websites may say they “accept” VSP only to offer a limited discount that is sub par to your in-network benefits. To be clear, these locations are actually out-of-network.

In a recent survey, members told us that this marketing tactic confuses them into thinking they were using their benefits in-network only to find out later they paid more to go out-of-network. To avoid this altogether, we recommend finding a doctor on vsp.com because they are all in-network.

Insider Tip: If you go to an eye doctor that you didn’t find on vsp.com, ask them to verify they are in-network with VSP. If you’re still not sure, you can always call VSP members services. We’re here to help!

Using your benefits in-network is easy

VSP has the largest national network of independent eye doctors, meaning most members are within five miles of five VSP network eye doctors. All of this and no extra paperwork to fill out? Sounds like a great way to save time and money.

Prefer to shop online?

If shopping online is more your style, you can get contacts, glasses and sunglasses using your in-network VSP benefits on Eyeconic—the only online optical retailer that connects your eyewear, insurance coverage and eye doctor’s expertise.

Eye health is key to overall health

Don’t forget, visiting your eye doctor annually isn’t just about getting a cool new pair of frames or updating your contact lens prescription. Your eye doctor can help detect early signs of diabetes, hypertension and other serious diseases during your eye exam, making your eye doctor a key player in your overall health and wellness. Schedule that eye exam today!

32 Comments

  • jeff schwallie says:

    I find that using out of network providers for glasses is much cheaper. The in-network providers seem to charge a premium for eyeglasses. For my last set of glasses at in-network, I believe I was over $200 out of pocket after VSP. I recently paid ~$50 for out of network glasses after VSP. Something is just wrong if I can get the same quality product for much less money using out of network providers.

    • Terri says:

      I agree Jeff Schwallie. Don’t you just love their “Insider Tip” advice. Sure they want you to choose your prescription glasses with them. “Inside Tip” or not they still up-charge you where the sun doesn’t shine.

    • E. Teran says:

      In network providers provide more intense examinations and also have the ability to offer more contact lens fitting options. VsSP is designed to provide the best value of name brand quality frames and lenses at deep discounts. Out of network providers may be cheaper but you may be buying close outs, discontinued and or cheep frames that just will not last. I have seen many patients get lenses which should have been name brands and they actually are generic copies which are suboptimal in providing good visual corrections.. one clear example is patients getting coatings for anti reflection instead of standard of care items like crizal which have warranties. It’s all about profit! Out of network costs less or more but most of the time the patient is getting a imitation of the name brand and these glasses will not last.

      • David Salk says:

        I am an “out of network” provider. We do NOT provide cheap, closeouts, and generic copied lens. We provide an extensive inventory of the finest INDEPENDENT eyewear brands, and lenses that are thoughtfully selected based upon frame, prescription and lifestyle. We frequently service VSP members who are looking for a more comprehensive selection of frame designs than are available at many VSP practices.

  • Patricia Boston says:

    I choose to go to my already established out of network ophthalmologist, the claims i have should be available on your app.

  • Cynthia A Lentine says:

    What doctors are in my network?

  • Joel Blount says:

    Out of network apparently means out of my the question as VSP rejected the properly filed request for reimbursement following my eye exam. I went to a Costco who does accept VSP but the independent eye doctor with an office in the same store is not in network. I submitted my recipe via the VSP site and received a reply in the mail that I was denied and can appeal if I so choose. Very disappointing.

  • Dave Stewart says:

    Just wondering , I went to Costco for my eye exam which I was told is out of network, am I able to get reimbursed any amount that I paid out of pocket? Thank you for your time

  • Is Kaiser part of the network? Thanks

    • Angelina F. says:

      No, Kaiser is out of network. To find a VSP network provider you can use the Find a Doctor search on vsp.com
      -Angelina F., VSP

  • I live in the San Antonio area on the SE side in Adkins, Tx

  • John Cassin says:

    I find that in network doctors charge more than Costco and have lots of up charges over the 105.00 reimbursed max on my plan.How do I get the new updated scribt and one more gas perm. lens from my plan ?

    • Dee says:

      My in-network provider offers substandard products at a very expensive price, then blames VSP for the poor-quality frames and lenses. I’ve found that what works best for me is to go to the in-network doctor for the exam, then buy the specs/contacts retail. I’ve heard great things about Costco and have never been disappointed by 1-800-CONTACTS.

    • Karen Patterson says:

      Your current Dr should send you a copy of your medical record and the prescriptions that you use. No problem. If they refuse, report them.

  • Jesus ramirez says:

    I have cigna insurance and l tray to make appointment but l don’t now how

  • Rhonda says:

    My eye doctor that I have gone to for 15 years has notified me that they will no longer work with VSP and that I will have to direct bill them myself. Pretty frustrating that VSP won’t work with them to accommodate us, there are several people in our organization that use the same doctor(s).

  • Gerald Holdridge says:

    It certainly would be nice to have Ophthalmologists on your list of network doctors. This to My wife and me is the biggest missing element in your plan. I know that can submit examination expenses manually, but it always is a hassle. In addition, when reimbursed, I get a suggestion that if I had gone to one of your network doctors, I would not have to send in the forms. This le like stabbing me in the back and giving the knife a twist!

  • Jeanette says:

    My husband uses a “premier” optometrist, and paid $150 for exam, progressive and transition lenses, frames, crizal. My optometrist is not “premier”, and I paid more than double that for NO eye exam, progressive lenses, crizal. Is this normal? I’ve used my doctor for nearly 40 years, but that seems to be too much difference in cost.

  • Marcia B says:

    I went to a participating VSP optometrist for a 2nd pair of lenses (progressive, transition, non-scratch coating-no exam) to be put in old frames but forgot to mention I had VSP. I was charged over $500. When I contacted VSP, I was told to submit a claim but it had to be processed “out-of-network.” The result was a $50 reimbursement. Rather disappointed.

  • v says:

    Is Lens Crafters an in-network provider?

  • JS says:

    Are identical frames the same price, regardless of the In-Network provider you choose? Also, does VSP monitor what In-Network providers charge for eyewear? What controls are in place such that In-Network providers don’t take advantage of their favorable position, having “captive” customers.

  • Ken says:

    If I choose to go to an in network office for exam but want to take advantage of there promotions that can not be combined with insurance can I send in for out of network benefits?

    • Angelina F. says:

      Hi Ken,
      For questions regarding benefits please contact customer care at 800.877.7195.
      -Angelina F., VSP

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