|MetLife D130D Vision||IN-NETWORK||OUT-OF-NETWORK|
|Examination, Lenses/Contacts, Frames||Every 12 Months||Every 12 Months|
|Examination||$15 copay||up to $45|
|Single Vision||$15 copay||up to $30|
|Bifocal||$15 copay||up to $50|
|Trifocal||$15 copay||up to $65|
|Frame||Up to $130 Retail Allowance, Costco $70||up to $70|
|Contact Lenses: Elective Medically Necessary||Up to $130 Retail Allowance Covered in full after eyewear||up to $105 up to $210|
|Laser Vision Correction||Discount May Apply||N/A|
- MetLife Vision Package: This packet from MetLife provides a wealth of information regarding the plan. It includes an overview of how the plan works, covered and excluded services, FAQ’s, and the Schedule of Benefits (Fee Schedule/Price List).
- MetLife Vision ID Card– Metlife does not issue ID cards for the PPO plan. Your SSN is your ID number. The BankUnited group number is 150917. You may use this generic ID card but it is not required.
- To find a MetLife network provider visit www.MetLife.com or call 1-800-942-0854