Benefits and Covered Services

Vision Services

If you are a San Francisco Health Plan Medi-Cal member, then you receive vision services through Vision Service Plan (VSP)

To find a VSP provider, visit vsp.com, or call 1(800) 877-7195.  VSP will give you contact information for a participating provider.

  1. When you call the participating provider, identify yourself as a VSP member.  The VSP participating provider will verify your eligibility and plan coverage.
  2. If you are eligible for services, your provider will schedule an appointment for you.  If you are not eligible for services, the VSP provider will tell you.
  3. Call Vision Service Plan (VSP) at 1(800) 438-4560 to get more information about your vision service benefit.
  4. Vision benefits for children under the age of twenty-one (21) include eye exams from an optometrist once every 24 months. Frames and lenses are covered.
  5. Vision benefits for adults age twenty-one (21) and older include eye exams from an optometrist once every 24 months. Frames and lenses are not covered.
  6. Because of the risk that diabetes poses to vision, it is important for SFHP members with diabetes to get their routine eye exams. Routine dilated eye exams by VSP optometrists are covered annually every 12 months for diabetic patients.
  7. There is no limitation to the frequency of medically necessary exams by ophthalmologists, nor limitations on the treatment of abnormal retinal exams. If more frequent exams are required, your doctor can refer you to an ophthalmologist.

If you have any other questions about your Medi-Cal vision benefits, email San Francisco Health Plan Customer Service, or call us at 1(800) 288-5555, Monday through Friday, 8:30am to 5:30pm.