Vision Insurance

Help protect your family’s eyesight and overall vision health while saving on
out of-pocket expenses1 with MetLife’s comprehensive vision insurance options.

Get Annual Eye Exams

Annual eye exams help protect your vision and your overall health.
Did you know that you can save up to 60%4 on vision services and eyewear, including annual exams and evaluations? Choose from thousands of
vision providers near you.

Find a Vision Provider

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

Your Vision Plan Summary

Summary of Benefits
VISION

Class Description

All Active Members | Plan Name | M130D-10/25 | Reimbursement
In-Network Coverage (Using a Network Provider) | Out-of-Network
Reimbursement (Using a Non-Network Provider) | Eye Examination

Comprehensive exam of visual functions
and prescription of corrective eyewear.

$10 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
Materials / Eyewear
(Either Glasses or Contacts)

Standard Corrective Lenses

Single vision Lined bifocal Lined trifocal Lenticular
$25 copay
$30 allowance		 $25 copay
$50 allowance		 $25 copay
$65 allowance		 $25 copay
$100 allowance

Standard Lens Enhancement

Ultraviolet coating
Covered in Full		 Standard Polycarbonate
(child up to age 18)
Covered in Full		 Progressive Standard Progressive
Premium/Custom
Applied to the
allowance for
the applicable
corrective lens		 Applied to the
allowance for the
applicable corrective
lens Additional Lens
Enhancements1		 Up to $55 copay
$50 allowance		 Premium: Up to
$95-$105 copay

Summary of Benefits
VISION

Class Description All Active Full Time Employees (30 Hours)
Plan Name M130D-10/25
Reimbursement In-Network Coverage
(Using a Network Provider)		 Out-of-Network Reimbursement
(Using a Non-Network Provider)
Eye Examination
Comprehensive exam of
visual functions and
prescription of corrective
eyewear. 		$10 copay $45 allowance
Up to $39 copay Applied to the exam allowance
Materials / Eyewear
(Either Glasses or Contacts)
Standard Corrective Lenses
  • Single vision
  • Lined bifocal
  • Lined trifocal
  • Lenticular
  • $25 copay
  • $25 copay
  • $25 copay
  • $25 copay
  • $30 allowance
  • $50 allowance
  • $65 allowance
  • $100 allowance
Standard Lens Enhancement
  • Ultraviolet coating
 Covered in Full Applied to the allowance for the
applicable corrective lens
  • Standard Polycarbonate
    (child up to age 18)
 Covered in Full Applied to the allowance for the
applicable corrective lens
Additional Lens Enhancements 1
  • Progressive Standard
 Up to $55 copay $50 allowance
  • Progressive Standard
 Up to $55 copay $50 allowance
  • Progressive Premium/Custom
 Premium: Up to $95-$105 copay
Custom: Up to $150-$175 copay		 $50 allowance
  • Standard Polycarbonate (adult)
 Single 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 copay Applied to the allowance for the
applicable corrective lens
  • Tints (plastic lenses)
 Pink I & II: $0 copay
Solid Plastic: $15 Copay
Plastic Gradient Dye: $17 Copay		 Applied to the allowance for the
applicable corrective lens
  • Anti-reflective coating
    (variable by type)
 Up to $41 - $85 copay Applied to the allowance for the
applicable corrective lens
  • Photochromic
    (variable by type)
 Up to $47 - $82 copay Applied to the allowance for the
applicable corrective lens

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, Walmart
and Sam’s Club.)

  • Scratch-resistant coating (variable by type)
 $130 allowance $150 allowance on
featured frames


$70 allowance 		$70 allowance
Contact Lenses
  • Elective
 $130 allowance $105 allowance
  • Necessary
 Covered in full after
eyewear copay		 $210 allowance
  • Contact Fitting and
    Evaluation
 Standard or Premium fit:
Copay not to exceed $60		 Applied to the contact
lens allowance
Value Added Features
  • Additional Savings on
    Glasses and Sunglasses1
 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 correction22
 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.

  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, Walmart and Sam’s Club 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.

Frequency / Exclusions

Class Description: All Active Full Time Employees
Frequencies
  • Examinations
  • 1 per 12 Months
  • Standard Corrective Lenses
  • 1 per 12 Months
  • Frames
  • 1 per 24 Months
  • Contact Lenses
  • 1 per 24 Months
  • Either glasses or contacts allowed
    per frequency

Exclusions

  • Services and/or materials not specifically included in the Summary of Benefits as covered Plan Benefits.
  • Any portion of a charge in excess of the Maximum Benefit Allowance or reimbursement indicated in the Summary of Benefits.
  • Plano lenses (lenses with refractive correction of less than ± .50 diopter)
    Two pairs of glasses instead of bifocals.
  • Replacement of lenses, frames and/or contact lenses furnished under this Plan which are lost, stolen or damaged, except at the normal intervals when Plan Benefits are otherwise available.
  • Orthoptics or vision training and any associated supplemental testing.
  • Medical or surgical treatment of the eyes.
  • Prescription and non-prescription medications.
  • Contact lens insurance policies or service agreements.
  • Refitting of contact lenses after the initial (90-day) fitting period.
  • Contact lens modification, polishing or cleaning.
  • Local, state and/or federal taxes, except where MetLife is required by law to pay.
  • Any eye examination or any corrective eyewear required as a condition of employment.
  • Services and supplies received by You or Your Dependent before the Vision Insurance starts for that person.
  • Missed appointments.
  • Services or materials resulting from or in the course of a Covered Person’s regular occupation for pay or profit for which the Covered Person is entitled to benefits under any Workers’ Compensation Law, Employer’s Liability Law or similar law. You must promptly claim and notify the Company of all such benefits.
  • Services: (a) for which the employer of the person receiving such services is not required to pay; or (b) received at a facility maintained by the Employer, labor union, mutual benefit association, or VA hospital.
  • Services or materials received as a result of disease, defect, or injury due to war or an act of war (declared or undeclared), taking part in a riot or insurrection, or committing or attempting to commit a felony.
  • Services and materials obtained while outside the United States, except for emergency vision care.
  • Services, procedures, or materials for which a charge would not have been made in the absence of insurance.