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AFT Vision Insurance

Spectera Vision Program

Available to AFT members as a part of the

Limited Supplemental Medical Plan


 

Benefits                        In-Network                  Out-of-Network

Vision Exam

100% after $10  co-pay  

 Up to $40

Frames

100%

Up to $45

Single lenses

100% after $25 co-pay

Up to $40

Bifocal

100% after $25 co-pay

Up to $60

Trifocal

100% after $25 co-pay

Up to $80

Lenticular

100% after $25 co-pay

Up to $80

Contact Lenses



Conventional

100% after $25 co-pay

Up to $105

Disposable

100% after $25 co-pay

Up to $105

Medically Necessary

100% after $25 co-pay

Up to $210


 Using the plan:
The Spectera vision program offers both in and out-of-network benefits.  Spectera’s national network offers choice and convenience with a diverse network of more than 23,000 providers. When making an appointment, simply give the Spectera provider the subscriber’s unique identification number, along with the patient’s name and date of birth, and identify the patient as a Spectera member. The provider will verify the patient’s eligibility and coverage prior to the scheduled appointment.

If you choose an out-of-network provider, simply pay the provider in full at the time of service. To request reimbursement, submit your receipts to:

Spectera Claims Department

PO Box 30978

Salt Lake City, UT84130

-or-

Fax: 248-733-6060

The following information should be included with your receipt submission:

– Member’s name and address

– Patient’s name and date of birth

– Patient's unique identification number

To locate a participating provider in your area, go to www.spectera.com

To enroll in this program, please call 888/423-8700

*

For informational purposes only. Please refer to your policy for full details.




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