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Vision Benefits





         MetLife | PPO Vision Plan
         The MetLife vision plan provides professional vision care and high quality lenses and frames through a broad network of
         optical specialists. You will receive richer benefits if you utilize a network provider. If you utilize a non‐network provider, you
         will be responsible to pay all charges at the time of your appointment and will be required to file an itemized claim with
         MetLife.


                                                                              MetLife
                      Plan Type:
                                                                             PPO Plan
                    Network Type:                          In-Network                       Out of Network

         Vision Benefits
         Copay
          - Examination (Every 12 Months)                   $10 Copay                     Reimbursed up to $45

         Lenses (Every 12 Months)
          - Single Vision                                   $25 Copay                     Reimbursed up to $30
          - Bifocal                                         $25 Copay                     Reimbursed up to $50
          - Trifocal                                        $25 Copay                     Reimbursed up to $65
          - Lenticular                                      $25 Copay                     Reimbursed up to $100

                                                In-Network: $25 Copay, $130 Allowance
         Frames (Every 12 Months)               Costco: $25 Copay, $70 Allowance; 20%     Reimbursed up to $70
                                                       off balance over Copay
         Contact Lenses (Every 12 Months)                             In Lieu of Frames and Lenses
          - Elective                                      $130 Allowance                  Reimbursed up to $105
          - Medically Necessary                      $25 Copay, Covered in Full           Reimbursed up to $210

                                                15% off retail price or 5% off promotion
         Laser Vision Correction                                                                  N/A
                                                  price only at participating locations





           Note: The MetLife Vision network includes access to independent ophthalmologists and optometrists, as well as Costco
           Optical, Pearle Vision, America’s Best, Cohen’s, and VisionWorks retail stores.







                     Finding In-Network Vision Providers

                     Go to www.metlife.com/insurance/vision-insurance or call (855) 638-3931


















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