Vision
coverage is one of the most attractive benefits a company can provide
its members. That's why MorganWhite offers both voluntary and employer
paid vision plans to meet the needs of employers and members alike.
Plan
Features
No Deductible
No Waiting Period
No Industry Exclusions
One Rate for Employer Paid or Voluntary - 47
States
One Pair of Spectacle Lenses or Contact Lenses,
each 12 months
One Set of Frames each 24 months
Laser Eye Surgery Benefits through The Laser
Vision Network of America (LVNA)
In-Network Benefits $20
Co-Payment Use
one of Spectera, Inc.'s retail chain eye care providers
Spectacle
Lenses
Single Vision
100%
Bifocal
100%
Trifocal
100%
Lenticular
100%
Frames
100%
Elective
Contact Lenses
Covered-in-full
contacts
100%
All
other elective contacts
up
to $105.00
Necessary
Contact Lenses
100%
• Retail Chain Network Benefits – Materials
$20.00 copay and patient options are paid to the network provider
by the plan participant.
• Frame Benefit – Spectera, Inc.’s
generous frame benefit applies to virtually all of the frames on the
market today, and most of those are covered-in-full, with no additional
cost to the member, other than applicable copays. With Spectera, Inc.’s
frame benefit, plan participants receive a minimum $130 frame allowance
for frames purchased at retail chain providers.
• Contact lenses are provided in lieu of spectacle
lenses and frames. Spectera, Inc.’s contact lense benefit covers
in full (after applicable copay) the fitting/evaluation fees, contacts
(disposable contacts/up to 4 boxes, depending on prescription and
plan selected), and up to two follow-up visits. A $105 allowance is
applied toward the fitting/evaluation fees and purchase of contact
lenses outside of Spectera, Inc.’s covered-in-full contacts
(materials copay does not apply). Toric, gas permeable, and bifocal
contacts are all examples of contacts that are outside of our covered-in-full
selection.
• Necessary contact lenses are determined
at the provider’s discretion for one or more of the following
conditions: Following post cataract surgery without intraocular lens
inplant; To correct extreme vision problems that cannot be corrected
with spectacle lenses; With certain conditions of anisometropia; With
certain conditions of keratoconus.
Out-of-Network Benefits Use
the eye care provider of your choice
Spectacle
Lenses
Single Vision
up
to $40
Bifocal
up
to $60
Trifocal
up
to $80
Lenticular
up
to $80
Frames
up
to $80
Elective
Contact Lenses
Covered-in-full
contacts
up
to $105
All
other elective contacts
up
to $105
Necessary
Contact Lenses
up
to $210
• Out-of-Network Benefits – The plan
participant pays full fee to the provider and Spectera Inc. reimburses
the participant for services rendered up to maximum allowance. There
are no copays or deductibles.
When
scheduling your appointment, be sure to say that you are covered under the
MorganWhiteGroup / Spectera Inc. Materials Only
Vision Plan so that the provider can confirm
your eligibility and benefits prior to the appointment.
Frequently Asked Questions
Q.Who will provide
my vision benefits?
A. Spectera, Inc. - Customer Service may be
reached at 800-638-3120. Once you are enrolled in a MWG Vision plan
you can access claim and benefit information by clicking on the Members
Section on our web site (www.mwgvision.com).
•
For Benefit Information
• For Claim Information
Q. How soon can
I use my benefits?
A. On the first day your plan is effective.
Q. Can I receive
in-network benefits at private practice and retail chiain providers?
A. For in-network benefits you need to go to
a Retail Chain Provider.
Q. How do I locate
an in-network retail chain provider?
A. Call: Provider location service at 800-839-3242
- specify Retail Chain Provider or click on National
Directory – Retail Chain Providers.
Q. Can you describe
the benefits in more detail?
A. In-Network
Benefits
LENSES: If prescribed, a pair of single vision or standard lined multi-focal
lenses every 12 months with only a $20.00 co-pay.
CONTACT LENSES: In lieu of spectacle lenses and a frame, you may select
contact lenses every 12 months with only a $20.00 co-pay. Spectera,
Inc. covers a wide variety of contact lenses, including disposable,
when obtained from a participating retail chain provider. If you elect
contact lenses outside of Spectera, Inc.’s covered selection,
you will receive an allowance of $105.00 toward the retail cost of
the lenses and any dispensing and fitting fees.. There is a $210 allowance
for “medically necessary” contacts. (When your vision
cannot be corrected to better than 70/20 with standard lenses). Any
amount over the allowance is the patient’s responsibility.
FRAMES: Your choice from a wide selection of fashionable frames will
be covered-in-full every 24 months. (Co-pay for frames is included
with lenses) your plan covers a minimum of $130 retail frame allowance
any cost incured above the $130 allowance is the patient’s responsibility.
PATIENT OPTIONS: Should you select items not covered by the program,
such as: progressive lenses, tints, coatings, etc., there will be
an additional charge. These charges, however, are below usual retail
costs. (Standard Scratch coating is covered in full at no cost to
the insured).
Q.
Out-of-Network Benefits – What is the reimbursement procedure?
A. Spectera, Inc. will accept receipts, and reimburse you once (up
to the amounts shown on the other side of this flyer), each 12 months
(frames each 24 months) (from date of service) when you use an “out-of-network”
provider. While you can file for reimbursement anytime after you receive
your eyewear, in order to maximize your “out-of-network”
benefits, itemized receipts should be collected (i.e. several purchases
of contact lenses) until they total (at least) the maximum reimbursement
amounts shown on the other side of this sheet. Be sure to include
the participant’s social security number, patient’s name
and date of birth with the receipts.
MAIL TO: Spectera, Inc., PO Box 26618, Baltimore, MD 21207-6618
Q.
Out-of-Network Benefits – Can I go to any eye care provider?
A. Yes, you can use any eye care provider.
Access to Refractive
Eye Surgery Procedures
The Laser Vision
Network of America
(LVNA), a nationwide network servicing Spectera, Inc. members, is
comprised of more than 300 laser vision providers. The network
was established in 1999 and offers the most extensive geographic coverage
in the U.S. We currently serve over 75 million members through
some of the largest health and vision insurers in the industry.
All surgeons are credentialed
to NCQA recommended standards ensuring the highest quality in patient
care.
By combining LasikPlus Vision Centers with independent surgeons,
members have the broadest choice of laser technology in the industry.
Our call center is staffed exclusively with LASIK trained representatives
available to assist you 7 days a week.
As a participating provider in this panel, our surgeons make laser
vision correction more available and affordable to millions of potential
patients. Members and dependents are entitled to one of the
following discounts not available to the general public:
• 15%
off "Standard" or "Usual & Customary" Price
- or -
• 5% off any Promotional Price
Not only are members
given a meaningful discount, but that discount is applied to prices
that are below the national average. See comparison below:
Average Prices for
LASIK:
National = $1,700
per eye
LVNA = $1,560
per eye (prior to discount)
LasikPlus Vision Centers,
which are part of the LVNA = $ 1,300 per eye (prior to discount)