T-Mobile offers vision coverage through Vision Service Plan (VSP), which offers a broad network of nationwide providers to choose from to meet your vision needs.

The plan covers eye exams and glasses or contact lenses. Copays and benefit maximums apply. Frequencies and maximums of benefits are based on a calendar year.

What’s covered How often Copays and maximums
Eye exams One per year Copay: $15
Lenses (for glasses) One pair per year Copay: $25 (combined with copay for frames)
Frames One pair per year Copay: $25 (combined with copay for lenses)
Maximum benefit: up to $150 after copay
Contact lenses One pair per year (in lieu of glasses) Copay: none
Maximum benefit: up to $150 per pair

Provider Contact
To find a VSP doctor, review their website at vsp.com or call (800) 877-7195 and mention group #12122822.
VSP Customer Care Hours:
Monday – Friday: 5 a.m. to 8 p.m. Pacific
Saturday: 7 a.m. to 8 p.m. Pacific
Sunday: 7 a.m. to 7 p.m. Pacific

COSTS

Bi-Weekly Costs for Vision Plans (No Domestic Partner Enrolled)

Plan Year: Jan 1, 2019 – Dec 31, 2019

Coverage Election Vision
  Employee Employer
Employee Only $3.00 $0.00
Employee plus Spouse $5.00 $0.00
Employee plus Children $5.00 $0.00
Employee plus Family $8.00 $0.00

Domestic Partner2 Enrolled: Bi-Weekly Pre-Tax vs Post-Tax Contributions for Vision Plans

Plan Year: Jan 1, 2019 – Dec 31, 2019

Coverage Election Vision
  Pre-Tax Post-Tax
Employee plus DP $3.00 $2.00
Employee plus Children
(where only DP children are covered)
$3.00 $2.00
Employee Plus Family
(where DP and at least one non-DP child are covered)
$6.00 $2.00
Employee Plus Family
(where DP and only DP child(ren) are covered)
$4.00 $4.00
Employee Plus Family
(where no DP and only DP child(ren) are covered)
$6.00 $2.00

Domestic Partner3 Enrolled: Bi-Weekly Imputed Income

Plan Year: Jan 1, 2019 – Dec 31, 2019

Coverage Election Vision
Employee plus DP $0.00
Employee plus Children
(where only DP children are covered)
$0.00
Employee Plus Family
(where DP and at least one non-DP child are covered)
$0.00
Employee Plus Family
(where DP and only DP child(ren) are covered)
$0.00
Employee Plus Family
(where no DP and only DP child(ren) are covered)
$0.00

2You are responsible for paying both the pre-tax and the post-tax portion of the contribution.

3This represents the amount that T-Mobile pays for your domestic partner’s coverage. Because the IRS doesn’t consider them to be a tax dependent, this amount is added to your paycheck as taxable income.