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Vision Insurance Plan Year 2012 Optum Health Vision/Spectera.

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Presentation on theme: "Vision Insurance Plan Year 2012 Optum Health Vision/Spectera."— Presentation transcript:

1 Vision Insurance Plan Year 2012 Optum Health Vision/Spectera

2 February 2010 2 APRIL 2010 Vision  Coverage level available:  4 Tier Structure I.Employee, II.Employee+Child, III.Employee+Spouse, IV.Family  Pre-tax premiums  Network of eye care providers  Benefits available for in-network & out-of-network services

3 February 2010 3 APRIL 2010 Vision  Frequency:  Routine Eye Exams: every 12 months  Lenses: every 12 months  Frames: every 24 months  Contacts: every 12 months

4 February 2010 4 APRIL 2010 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 February 2010 5 APRIL 2010 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 February 2010 6 APRIL 2010 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 February 2010 7 APRIL 2010 Benefits Chart * Only a one time $20 material copay applies per benefit period.

8 February 2010 8 APRIL 2010 Benefits Chart * Only a one time $20 material copay applies per benefit period.

9 February 2010 9 APRIL 2010 Benefits Chart * Only a one time $20 material copay applies per benefit period.

10 February 2010 10 APRIL 2010 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 February 2010 11 APRIL 2010 Benefits Chart

12 February 2010 12 APRIL 2010 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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