| Vision Plan | In-Network Costs | Out-of-Network Reimbursement |
|---|---|---|
| Exam - Once every 12 months | ||
| Eye health exam, dilation, prescription, and refraction for glasses | Covered in full after $10 copay | Up to $45 |
| Retinal imaging | Up to a $39 copay on routine retinal screening when performed by a private practice | N/A |
| Materials and Eyewear - Once every 12 months | $10 copay for materials and eyewear | N/A |
| Lenses - Once every 12 months | ||
| Single / Lined Bifocal / Lined Trifocal / Lenticular | Covered after $10 eyewear copay | Up to $30 / $50 / $65 / $100 |
| Basic Progressive Lens | Covered in full after $55 copay | Up to $50 |
| Frames – Once every 12 months | ||
| Allowance* | $130 allowance after $10 eyewear copay | Up to $55 |
| Costco, Walmart, Sam’s Club | $70 allowance after $10 eyewear copay | N/A |
| Contacts (in lieu of eye glasses) – Once every 12 months | ||
| Necessary | $130 allowance after $10 eyewear copay | Up to $210 |
| Elective | Up to $130 allowance | Up to $105 |
| Second Pair of Glasses | ||
Additional: A second set of glasses or contacts is available in the same plan year. Applicable copays apply. Two pairs of prescription eyeglasses; or One pair of prescription eyeglasses and an allowance toward contact lenses; or Double your contact lens allowance | ||
| Laser Vision Correction | ||
| Savings averaging 15% off the regular price or 5% off a promotional offer for laser surgery including PRK, LASIK, and Custom LASIK. This offer is only available at MetLife participating locations. | ||
| *You will receive an additional 20% savings on the amount that you pay over your allowance. This offer is available from all participating locations except Costco. | ||