This VSP vision plan is only available to those enrolling in the Delta Dental PPO plan. Vision plans are not available in Florida or Oregon.
Deductible: This is a Discount Plan. Copay: N/A
| Code | Description | Plan Cost | Normal Cost | Savings |
|---|---|---|---|---|
| 0120 | Periodic Oral Evaluation | $24 | $50 | 53% |
| 0274 | Bitewings — Four Films | $31 | $66 | 54% |
| 1110 | Prophylaxis — Adult (light) | $48 | $97 | 51% |
| 1120 | Prophylaxis — Child | $34 | $70 | 52% |
| 2160 | Amalgam — Three Surface, Primary or Permanent | $99 | $220 | 55% |
| 2750 | Crown — Porcelain Fused to High Noble Metal | $600 | $1,125 | 46% |
| 3330 | Root Canal — Molar (Excluding Final Restoration) | $580 | $1,035 | 44% |
| 4341 | Periodontal Scaling and Root Planning | $124 | $275 | 52% |
| 7140 | Extraction — Erupted Tooth or Exposed Root | $81 | $180 | 56% |
| 8080 | Comprehensive Orthodontic Treatment of the Adolescent Dentition | 20% Disc. | $5,581 | 20% |
To locate a participating provider, call toll-free 1-800-290-0523, use the Providers tab above or go online at www.careington.com to access the online provider search.
Members call to make an appointment with the participating provider. The member must show their membership card at the time of visit to receive the discount.
Pay the bill. The member is responsible for the total bill, less the applicable savings, at the time service is rendered.
| Monthly | Quarterly | Annually | |
|---|---|---|---|
| Member | $13.86 | $41.58 | $166.32 |
| PlusOne | $23.34 | $70.02 | $280.08 |
| Family | $35.73 | $107.19 | $428.76 |
One time Non Refundable Processing fee: $35.00
The stated rates above include a two dollar ($2) per month billing fee and one dollar ($1) per month fee for membership in the Benefits Association. Rates are guaranteed for a 12 month period, at which time rates may be subject to change. After your first renewal, the rates will be guaranteed for 12 months each year thereafter.
This plan is NOT insurance. This is NOT a Medicare Prescription Drug Plan.*
This plan does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. The plan provides discounts at certain health care providers for medical services. The range of discounts will vary depending on the type of provider and service. The plan does not make payments directly to the providers of medical services.
Plan members are obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount medical plan organization. You may access a list of participating health care providers at this website. Upon request the plan will make available a written list of participating health care providers.
The program and its administrators have no liability for providing or guaranteeing service by providers or the quality of service rendered by providers.
This program is not available in Montana and Vermont.
* Medicare statement applies to MD residents when pharmacy discounts are part of program.
You have the right to cancel within the first 30 days after receipt of membership materials and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5).
Discount Medical Plan Organization and administrator:
Careington International Corporation,
7400 Gaylord Parkway,
Frisco, TX 75034
Phone: 800-441-0380.
Easy, simply call your eye doctor to see if they are in fact a VSP Provider, call VSP's customer service line at 800.877.7195, or visit our providers section and check it out for yourself.
By visiting a VSP Provider you will be able to take full advantage of the benefits provided by this plan. Such as, the low co-payments for examinations and materials.
Yes, but you get the best value from your benefit when you see a VSP doctor. If you see a non-VSP provider, you'll typically pay more out-of-pocket. You'll pay the provider in full and have 6 months to submit a claim to VSP for partial reimbursement less co-pays. Before seeing a non-VSP provider, call us at 800.877.7195. You can see the out of network reimbursement amounts in the Plan Benefits section of the site.
Monthly bank draft or monthly credit card billing.
The draft will take place between the 1st and 5th of each month.
If your enrollment form is received by the 20th, your coverage begins the first of the following month.
Morgan White at 888.859.3795
VSP at 800.877.7195. You can also check the status of claims and review your benefits at https://vsp.com, by logging into the members section of the site.
No. Once enrolled, the plan will continue unless you send a cancellation notice. All cancellations require a 30 day notice via email to individualchanges@morganwhite.com or by fax to (601) 956-3795.