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Plan Description

 

KEY BENEFITS

  • Save on services that are standard benefits under this plan, including eye exams, glasses, contact fittings and more.

  • Convenience of visiting any licensed eye care professional. Or choose from the thousands of ophthalmologists, optometrists and opticians or retail chains.

  • Lowest out-of-pocket costs when you visit a participating vision care provider.


MetLife Vision can help you and your family see well, stay healthy, and save.

Help protect the eyesight and health of every member of your family, with lower out-of-pocket expenses for you. Save money on eye exams and lenses, and select from thousands of network specialists.


 MetLife Vision Low Plan
(M100D-20/20)
MetLife Vision High Plan
(M150A-0/0)
Enrollment Deadline18th of month Prior to Effective date18th of month Prior to Effective date
Provider SeachSearch for ProvidersSearch for Providers
ReimbursementIn-Network Coverage
(Using a Network Provider)
Out-of-Network Reimbursement
(Using a Non­Network Provider)
In-Network Coverage
(Using a Network Provider)
Out-of-Network Reimbursement
(Using a Non­Network Provider)
States Not Available
AK, AZ, CA, ID, LA, ME, MD, MT, NH, NM, OR, SD, WA, WV
Eye Examination
Comprehensive exam of visual functions and prescription of corrective eyewear.$20 copay$45 allowance$0 copay$45 allowance
Retinal Imaging
This screening is used to take pictures of the inside of the eye particularly the retina to look for possible changes.
Up to $39 copay

Applied to the exam
allowance

Up to $39 copayApplied to the exam
allowance
Materials / Eyewear (Either Glasses or Contacts)
Standard Corrective Lenses    
Single vision$20 copay$30 allowance$0 copay$30 allowance
Lined bifocal$20 copay$50 allowance$0 copay$50 allowance
Lined trifocal$20 copay$65 allowance$0 copay$65 allowance
Lenticular$20 copay

$100 allowance$0 copay$100 allowance
Standard Lens Enhancement
Ultraviolet coatingCovered in FullApplied to the allowance
for the applicable
corrective lens
Covered in FullApplied to the allowance for the applicable corrective lens
Polycarbonate (child up to age 18)Covered in Full

Applied to the allowance
for the applicable
corrective lens

Covered in FullApplied to the allowance for the applicable corrective lens
Additional Lens Enhancements (1)
Progressive StandardUp to $55 copay$50 allowanceUp to $55 copay$50 allowance
Progressive Premium/CustomPremium: Up to $95-$105 copay
Custom: Up to $150-$175 copay
$50 allowancePremium: Up to $95-$105 copay
Custom: Up to $150-$175 copay
$50 allowance
Polycarbonate (adult)Single Vision: Up to $31 copay
Multifocal: Up to $35 copay
Applied to the allowance for the applicable corrective lensSingle Vision: Up to $31 copay
Multifocal: Up to $35 copay
Applied to the allowance for the applicable corrective lens
Scratch-resistant coating
(variable by type)
Up to $17 -$33 copayApplied to the allowance for the applicable corrective lensUp to $17-$33 copayApplied to the allowance for the applicable corrective lens
Tints (variable by type)Single Vision: Up to $17-$34 copay
Multifocal: Up to $17-$44 copay
Applied to the allowance for the applicable corrective lensSingle Vision: Up to $17-$34 copay
Multifocal: Up to $17-$44 copay
Applied to the allowance for the applicable corrective lens
Anti-reflective coating (variable by type)Up to $41 -$85 copayApplied to the allowance for the applicable corrective lensUp to $41 -$85 copayApplied to the allowance for the applicable corrective lens
Photochromic (variable by type)Up to $47 -$82 copayApplied to the allowance for the applicable corrective lensUp to $47 -$82 copayApplied to the allowance for the applicable corrective lens
Frame Allowance
Frame Allowance (You will receive an additional 20% off any amount that you pay over your allowance. This offer is available from all participating locations except Costco.)

$100 allowance


$55 allowance


$150 allowance


$70 allowance
Costco$55 allowance $85 allowance 
Contact Lenses
Elective$100 allowance$80 allowance$150 allowance$105 allowance
NecessaryCovered in full
after eyewear copay
$210 allowanceCovered in full
after eyewear copay
$210 allowance
Contact Fitting and EvaluationStandard or Premium fit:
Covered in full with a maximum copay of $60
Applied to the contact lens allowanceStandard or Premium fit:
Covered in full with a maximum
copay of $60
Applied to the contact lens allowance
Value Added Features
Additional Savings on Glasses and Sunglasses (1)Get 20% off the cost for additional pairs of prescription glasses and non-prescription sunglasses, including lens enhancements. At times, other promotional offers may also be available.
Laser Vision correction (2)Savings averaging 15% off the regular price or 5% off a promotional offer for laser surgery including PRK, LASIK and Custom LASIK. Offer is only available at MetLife participating locations.
Frequency (Class Description: All Eligible Members)
Examinations1 per 12 Months
Standard Corrective Lenses1 per 12 Months
Frames
1 per 24 Months-Low Plan;
1 per 12 Months-High Plan;
Contact Lenses
(Either glasses or contacts allowed per frequency)

1 per 12 Months

(1) Member costs for listed lens enhancements will be limited to copays that MetLife has negotiated with participating providers. These copays can be viewed by members after enrollment at www.metlife.com/mybenefits. All lens enhancements are available at participating private practices. Maximum copays and pricing are subject to change without notice. Please check with your provider for details and copays applicable to your lens choice. Please contact your local Costco to confirm the availability of lens enhancements and pricing prior to receiving services. Additional discounts may not be available in certain states.

(2) Custom LASIK coverage only available using wavefront technology with the microkeratome surgical device. Other LASIK procedures may be performed at an additional cost to the member. Laser vision care discounts are only available from participating locations.

(3) Savings from enrolling in a MetLife vision benefits plan will depend on various factors including the cost of the plan, how often participants visit an eye-care professional and the cost of services and eyewear received.

Member costs for listed lens enhancements will be limited to copays that MetLife has negotiated with participating providers. These copays can be viewed by members after enrollment at www.metlife.com/mybenefits. All lens enhancements are available at participating private practices. Maximum copays and pricing are subject to change without notice. Please check with your provider for details and copays applicable to your lens choice. Please contact your local Costco to confirm the availability of lens enhancements and pricing prior to receiving services. Additional discounts may not be available in certain states.






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