Active Health Summary Plan Description
As of September 1, 2017
En Español (PDF)

10.5 Non-Panel Providers

If you do not wish to seek services from a doctor who is a member of the VSP network, you may go to any other licensed vision provider, pay the provider his/her full fee, and be reimbursed by VSP in accordance with the reimbursement schedule listed in the "Schedule of Benefits" above.

To receive reimbursement, you need to send your itemized receipt to VSP within six (6) months from your date of service. You should include the covered Participant's name, phone number, address, member ID, the name of the group, the patient's name, date of birth, phone number and address, and the patient's relationship to the covered member (such as spouse, child, etc.) along with your itemized receipt. Please keep a copy of the information for your records and send the originals to the following address:

VSP
OON Claims
P.O. Box 997105
Sacramento, CA 95899-7105