|
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.
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