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Vision Insurance Plan Year 2012 Optum Health Vision/Spectera

Vision Insurance Plan Year 2012 Optum Health Vision/Spectera. Vision. Coverage level available: 4 Tier Structure Employee, Employee+Child, Employee+Spouse, Family Pre-tax premiums Network of eye care providers Benefits available for in-network & out-of-network services. Vision.

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Vision Insurance Plan Year 2012 Optum Health Vision/Spectera

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  1. Vision InsurancePlan Year 2012Optum Health Vision/Spectera

  2. Vision • Coverage level available: • 4 Tier Structure • Employee, • Employee+Child, • Employee+Spouse, • Family • Pre-tax premiums • Network of eye care providers • Benefits available for in-network & out-of-network services

  3. Vision • Frequency: • Routine Eye Exams: every 12 months • Lenses: every 12 months • Frames: every 24 months • Contacts: every 12 months

  4. Vision Insurance Vision • $50 Wholesale allowance for Private Practice providers will be replaced with $130 Retail allowance • Participants will know how much they are required to spend • Participants will have more freedom of choice between Retail providers and Private Practice providers • Online ID cards will be provided for Participants • Participants log in to web site: www.myoptumhealthvision.com • ID cards can be printed for employee or family members • Log in with the employee’s identification number, enter the dependent’s last name and Date of Birth • No limit to the number of cards which can be printed

  5. Vision Select Plan • Vision Insurance (Select Plan) operates the same way as the Current Plan • Frequency and co-pays are the same • In-network Benefits are the same • Out-of-Network Reimbursements are the same

  6. Vision Select Plus Plan • Vision Insurance (Select Plus Plan) operates the same as the Select Plan with additional enhancements: • Higher maximum for contact lenses: $125 • Cosmetic lens options (i.e. Tints, UV coating, Basic Progressive, Polycarbonate) are covered • Glasses/frames/contacts co-pay for Select Plus Plan is $25

  7. Benefits Chart * Only a one time $20 material copay applies per benefit period.

  8. Benefits Chart * Only a one time $20 material copay applies per benefit period.

  9. Benefits Chart * Only a one time $20 material copay applies per benefit period.

  10. Medically Necessary contacts • OptumHealth Vision must establish that an eligible member has any of the following: • Keratoconus or irregular astigmatism • Anisometropia of 3.50 diopters or more • Post cataract surgery without intraocular lens • Visual acuity in the better eye of less than 20/70 with spectacles, but better than 20/70 with contacts

  11. Benefits Chart

  12. Reminders • If you use in-network providers, you are responsible only for your portion of cost. • If you decide to use a non-network provider, you pay everything and seek the out-of-network benefits payments schedule • Payment is made at the time of service • To be reimbursed for an non-network service, receipts must be submitted to OptumHealth • Receipts must be submitted together for services and materials purchased on different dates to receive reimbursement

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