Spectera Vision Insurance Coverage

What is Spectera Vision Insurance?

Vision insurance is a type of health benefit. It fully or partially covers the following:

• Eye exams
• Eye disorder treatments
• Glasses
• Contact lenses.⁷

Spectera is a type of vision insurance, underwritten by Golden Rule Insurance Company. It offers significant cost savings on eye care and eyewear.

Spectera vision insurance is tied to a broad provider network, allowing you to choose eye doctors and eyewear freely. This includes both ophthalmologists and optometrists.³

What is the Benefit of a Spectera Vision Plan?

Various types of Spectera vision plans cover all or part of eye care costs with no waiting periods.³ With these plans, you gain access to 20 to 40% discounts on:

• Various lens options
• Extra eyewear
• Laser vision correction
• Other vision services³

Types of Spectera Plans for Vision Coverage

There are several different types of Spectera plans for vision coverage. No two plans offer the same benefits.

You also have the option to choose from standalone vision insurance plans that cover glasses, contacts, or both. Or, you can combine dental insurance with your vision insurance through Spectera.⁶

Plans vary by state. Generally, you have two options:

1. Plan A: This covers your needs for eyewear or contact lenses instead of glasses
2. Plan B: This covers your needs for both contacts and glasses

Some states have a 12-month initial policy requirement.

Who is Eligible for Spectera Vision Insurance?

Spectera vision care insurance offers coverage for people of all ages. However, the primary insured must be at least 18 years old.³

Even people who are already covered under Medicare can apply for Spectera vision insurance.

What Does Spectera Cover?

Spectera has many vision benefits that cover a variety of eye-care needs. While plans vary and different eye doctors offer unique services, Spectera generally covers:

• Eye exams
• Lenses (including single-vision lenses, bifocals, trifocals, and lenticular lenses, as well as a standard scratch-resistant coating for lenses if prescribed)
• Contact lenses (including bifocal contact lenses, gas-permeable contact lenses, soft contact lenses, and disposable contact lenses)
• Prescription sunglasses
• Eyeglass frames
• Eyeglass fittings and adjustments

You may be covered for one eye exam in a 12-month period. Likewise, many plans offer new coverage for lenses or frames every year.

If you choose disposable contact lenses over extended-wear lenses, you may be eligible for coverage of several boxes yearly. Check the different vision plans to ensure you choose a comprehensive vision care plan that covers your needs.

What Doesn’t Spectera Cover?

While plenty of Spectera benefits help you cover the costs of your eye care, remember that not everything is covered. Unfortunately, Spectera doesn't cover:

• Certain surgical eye procedures
• Corrective vision treatments
• Experimental vision treatments
• Missed appointment charges
• Sales tax charges on services for vision care
• Eye exams required by employers as conditions of employment
• Eye care extras, like accessories
• Certain cosmetic contact lenses, like colored contacts
• Nonprescription eyewear (only prescription glasses and contacts are covered)
• Nonprescription contact lenses
• Broken eyeglasses

Also, if your eye doctor is not one of Spectera’s in-network providers, you may have to pay out of pocket. Similarly, if you need to purchase more contact lenses than your plan allows, you may need to pay out of pocket for them. Additional services, like more eye exams, may not be covered either.

Does Spectera Cover LASIK?

LASIK (laser-assisted in situ keratomileusis) is a type of refractive eye surgery that offers permanent results.¹ It uses lasers to correct issues like:

• Myopia (also known as nearsightedness)
• Hyperopia (also known as farsightedness)
• Astigmatism

However, insurance never covers LASIK eye surgery since it's considered an elective procedure. Most health insurance companies consider laser eye surgery a cosmetic procedure.

They do not cover laser eye surgery costs because it's not medically necessary.¹ Nonetheless, there are some alternative ways to help you save on LASIK eye surgery:

1. Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs)

Some patients tap into their FSAs or HSAs to cover the costs of LASIK. FSA and HSA accounts are both pre-tax accounts that you can use to pay for LASIK.² 

FSA accounts are offered through your employer and are typically tied to traditional health plans. Meanwhile, HSA accounts must be linked to plans with high deductibles.²

2. Health Reimbursement Accounts

Health reimbursement accounts are employer-funded health benefit plans that reimburse employees for certain out-of-pocket healthcare expenses. In some cases, they may also cover the costs of premiums for health insurance plans. You may be able to use a health reimbursement account to cover LASIK.²
 

3. Special Deals

Some eye care doctors or offices offer special deals. They may offer promotional discounts to attract and retain new patients.

4. QualSight LASIK

QualSight LASIK makes up the largest network of credentialed LASIK eye surgeons across the U.S. With Spectera insurance, you can access discounted laser procedures through QualSight LASIK.⁵

Talk to your eye doctor about whether or not LASIK is right for you. Your Spectera vision provider can also discuss alternative options.

Summary

Spectera Vision Insurance offers coverage and significant savings for eye care and eyewear. They offer various plans that provide 20 to 40% discounts on vision services.

Coverage is available for people of all ages. Remember to ask your doctor whether they're one of Spectera’s in-network providers.

Keep in mind there are things that Spectera doesn't cover. You should confirm whether your insurance covers the costs of your eye care needs.