Vision – City of Plano

The City’s vision plan is administered by MetLife and promotes preventive care through annual eye exams and provides allowance for corrective materials such as glasses and contact lenses. The MetLife Vision PPO network includes a variety of retail providers as well as a wide selection of independent optometrists, ophthalmologists, and opticians. To find an in-network provider, go to metlife.com, select “Find a Vision Provider” then select “MetLife Vision VSP Choice.”

Plan Summary

Benefits	In-Network Provider	Out-of-Network Provider
Comprehensive Vision Exam (once every calendar year)	$10 copay	Up to $45 allowance
Materials	$10 copay	See reimbursement amounts below
Standard Eyeglass Lenses (once every calendar year) single, bifocal, trifocal or lenticular	$10 copay	Up to $30 - $100 allowance
Lens Options -Polycarbonate - Child (up to age 18): -Polycarbonate - Adult: -Progressive:	Covered in full Single Vision - up to $31 copay / Multifocal - up to $35 copay / Standard - up to $55 copay / Premium - up to $105 copay / Custom - up to $175 copay	-N/A -N/A -Up to $50 allowance
Frames (once every calendar year)	Retail Allowance: $180 + 20% discount on remaining balance Wholesale Allowance: $100 (Costco, Walmart, Sam’s Club)	Up to $70 allowance
Contact Lenses (once every calendar year)	Elective: $180 allowance Medically Necessary: Covered in full after $10 copay	Up to $105 allowance Up to $210 allowance
Contact Lens Fitting & Evaluation	Covered in full with a maximum copay of $60	N/A
Second Pair Glasses or Contacts (once every calendar year)	This benefit gives you additional eyewear coverage including: • two pairs of prescription eyeglasses, or • one pair of prescription eyeglasses and an allowance toward contact lenses, or • double your contact lens allowance	Same as outof- network allowance above
Laser Corrections	Discounts available	Not Covered
* All “not to exceed” copays are subject to change without notice. At this time, all lens options and “not to exceed” copays are not available at Costco, Walmart and Sam’s Club. Please check with your provider for details and copays applicable to your lens choice.

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