Vision
Davis Vision by MetLifePrint this page
How It Works
- Convenient Network Locations — A national network of credentialed preferred providers throughout the 50 states.
- Freedom of Choice — Access to care through either our network of independent, private practice doctors (optometrists and ophthalmologists) or select retail partners.
These plans offer a network of providers that service your eye-care needs with only a modest member copayment shown in the Schedule of Benefits.
Out-of-network benefits
The out-of-network benefit allows you to select any provider and reimburses a fixed dollar amount based on the schedule shown for the out-of-network services*.
You will receive the greatest value and maximize your benefit dollars if you select a provider who participates in the network. However, you may choose an out-of-network provider, but you must pay the provider directly for all charges and then submit a claim for reimbursement.
*This is not a contract: This is a benefits highlights summary. All benefits are subject to the provisions and exclusions of the master contract.
Vision Bi-weekly Rates Per Pay Period
RATES | PREMIERE PLAN | LOW PLAN | ||
---|---|---|---|---|
20 PAY | 24 PAY | 20 PAY | 24 PAY | |
Employee Only | $4.57 | $3.81 | $3.50 | $2.92 |
Employee + Family | $13.03 | $10.86 | $9.98 | $8.32 |
Premiums may be paid either “before” or “after” taxes, and are deducted from your salary. |
Davis Vision Plan Features Summary
The following chart indicates the benefits the plan pays for the services you receive. For more information, see the Davis plan literature.
PREMIERE PLAN | LOW PLAN | BOTH PLANS | |
---|---|---|---|
In-Network | In-Network | Out-of-Network | |
SERVICES | |||
Eye Examination | Every Jan. 1, covered in full after $10 copayment. | Every Jan. 1, covered in full after $10 copayment. | Up to $35 |
Laser Surgery Benefit | $500 Lifetime Reimbursement | N/A | N/A |
EYEGLASSES | |||
Spectacle Lenses | Every January 1, covered in full for standard single-vision, lined bifocal, or trifocal lenses after $15 copayment. | Every January 1, covered in full for standard single-vision, lined bifocal, or trifocal lenses after $15 copayment. | Spectacle Lenses (per pair) up to: Single Vision: $25, Bifocal/progressive: $40, Trifocal: $60, and Lenticular: $100. |
Frames | $1506 Retail allowance toward any frame from provider, plus 20% off balance2. Also, up to $200 frame allowance at Visionworks, plus 20% on any overage OR Every January 1, covered in full any fashion or designer frame from Davis Vision’s collection1 (value up to $175). | $1306 Retail allowance toward any frame from provider, plus 20% off balance2. Also, up to $180 frame allowance at Visionworks, plus 20% on any overage OR Every other January 1, covered in full any fashion or designer frame from Davis Vision’s collection1 (value up to $175). | Up to $50 |
CONTACT LENSES | |||
Contact Lens Evaluation, Fitting & Follow Up Care | Every January 1, collection contacts: covered in full OR Non collection contacts: standard contacts: 15% discount2, specialty contacts3: 15% discount2. | Every January 1, collection contacts: covered in full OR Non collection contacts: standard contacts: 15% discount2, specialty contacts3: 15% discount2. | Elective Contacts: up to $150 Medically necessary contacts: up to $210 |
Contact Lenses (In Lieu of Eyeglasses) | $150 retail allowance toward provider supplied contact lenses, plus 15% off balance2 OR Every January 1, covered in full any contact lenses from Davis Vision’s contact lens collection1. | $150 retail allowance toward provider supplied contact lenses, plus 15% off balance2 OR Every January 1, covered in full any contact lenses from Davis Vision’s contact lens collection1. | N/A |
ADDITIONAL DISCOUNTED LENS OPTIONS & COATINGS | |||
Most Popular Options - Savings based on in-network usage and average retail values. | |||
PREMIERE PLAN | LOW PLAN | ESTIMATED RETAIL COST | |
Scratch-Resistant Coating (Standard/Premium) | $0 / $30 | $0 / $30 | $40 |
Polycarbonate Lenses | $04-$30 | $04-$30 | $64 |
Standard Anti-Reflective (AR) Coating | $35 | $35 | $62 |
Standard Progressives (no-line bifocal) | $50 | $50 | $154 |
Plastic Photosensitive (Transitions®5) | $65 | $65 | $123 |
FRAMES - ADDITIONAL OPTIONS | |||
Fashion Frame (From the Davis Vision Collection) | $0 | $0 | $125 |
Designer Frame(From the Davis Vision Collection) | $0 | $0 | $175 |
Premier Frame(From the Davis Vision Collection) | $0 | $25 | $225 |
LENSES | |||
All Ranges of Prescriptions and Sizes | $0 | $0 | $90 |
Plastic Lenses | $0 | $0 | $33 |
Oversized Lenses | $0 | $0 | $20 |
Tinting of Plastic Lenses | $0 | $0 | $20 |
Scratch-Resistant Coating (Standard/Premium) | $0 / $30 | $0 / $30 | $40 |
Polycarbonate Lenses | $07 or $30 | $07 or $30 | $64 |
Ultraviolet Coating | $12 | $12 | $28 |
Standard Anti-Reflective (AR) Coating | $35 | $35 | $62 |
Premium AR Coating | $48 | $48 | $80 |
Ultra AR Coating | $60 | $60 | $113 |
Standard Progressive Additional Lenses | $50 | $50 | $154 |
Premium Progressives (Varilux®8, etc.) | $90 | $90 | $248 |
Ultra9 Progressive Addition Lenses | $140 | $140 | $430 |
High-Index Lenses (1.67/1.74) | $55/$120 | $55/$120 | $120 |
Polarized Lenses | $75 | $75 | $103 |
Plastic Photosensitive Lenses (Transitions®5) | $65 | $65 | $123 |
Scratch Protection Plan Single Vision/Multifocal Lenses | $20/$40 | $20/$40 | N/A |
1 The Davis Vision Collection is available at most participating independent provider locations. Collection is subject to change. Collection is inclusive of select toric and multifocal contacts. 2 Additional discounts not applicable at Walmart, Sam’s Club or Costco® locations. 3 Including, but not limited to toric, multifocal and gas permeable contact lenses. 4 For dependent children, monocular patients and patients with prescriptions of 6.00 diopters or greater. 5 Transitions® is a registered trademark of Transitions Optical Inc. 6 Enhanced frame allowance of $180 (low plan) $200 (premiere plan) only available at Visionworks® locations nationwide. 7Polycarbonate lenses are covered in full for dependent children, monocular patients and patients with prescriptions 6.00 diopters or greater. 8Varilux® is a registered trademark of Societe Essilor International. 9Category includes digital free-form progressive lenses. | |||
Davis Vision has made every effort to correctly summarize your vision plan features. In the event of a conflict between this information and your organization’s contract with Davis Vision, the terms of the contract or insurance policy will prevail. |