|
A Family Vision Plan offered by Spectera A UnitedHealth Group company,
Spectera provides group vision care benefit plans through a
nationwide network of over 16,000 private practice and retail
optical providers.
Level Of Benefits
| Examination |
Once Every 12 Months |
| Lenses |
Once Every 12 Months |
| Frames |
Once Every 24 Months |
Benefits at an
In-Network Provider1
|
Service |
Coverage |
Description |
| Examination |
100% |
Comprehensive vision examination
|
| Spectacle Lenses |
100% |
When prescribed, a pair of clear single vision or
standard lined multi-focal lenses. |
| Frames |
100% |
Spectera's participating providers have a selection
of over 100 frames that are covered in full. In
addition, members may select any frame and receive a
generous allowance towards the reduced price of their
selection. Members are only responsible for the
difference. More than 80% of Spectera's members select a
covered frame. |
| Contact Lenses (in lieu of lenses and
frame) |
100% |
Over 50 varieties covered in full, including contact
lens evaluation and fitting fees. You will receive a
$105 allowance toward all other contact lenses and
fitting/evaluation fees. |
| Patient Options |
Generous Discount |
All patient options, including
progressive lenses,
scratch coating, and tints, are available at
pre-negotiated reduced fees. |
| Co-Pays |
|
Exam: $10.00; Materials: $25.00
|
Benefits at an Out-Of-Network Provider2
|
Service |
Reimbursement Schedule |
| Examination |
Up to $40.00
|
| Single Vision |
Up to $40.00
|
| Bifocal |
Up to $60.00
|
| Trifocal |
Up to $80.00
|
| Lenticular |
Up to $80.00
|
| Frame |
Up to $45.00
|
| Necessary Contact Lenses
|
Up to $210.00
|
| Elective Contact Lenses
|
Up to $105.00
|
Weekly Rates
| Contractor Only |
$1.85 |
| Contractor Plus One
|
$3.24 |
| Contractor Plus Family
|
$5.50 |
1Participating Provider
(In-Network) - co-payments if applicable, and patient options
are paid to participating provider by plan participant
2Non-participating Provider
(Out-Of-Network) - participant pays full fee to provider and
Spectera reimburses the member for services rendered up to
maximum allowance. Co-payments are not required for
out-of-network benefits.
|
