MetLife Federal Plan Vision FAQs

The Federal Employees Dental and Vision Insurance Program (FEDVIP) is a voluntary, enrollee-pay-all dental and vision program that offers eligible participants a choice between 12 dental and five vision carriers, with some plans offering both high and standard options. Enrollee-pay-all means there are no government contributions toward premiums.

BENEFEDS is the government-authorized and U.S. Office of Personnel Management (OPM)-sponsored enrollment portal that you'll use to enroll in FEDVIP coverage. BENEFEDS also manages the billing systems and customer service functions necessary for the collection of FEDVIP premiums.

The Federal Benefits Open Season (or open season) is your annual opportunity to enroll in, make changes to, or cancel enrollment in a FEDVIP dental and/or vision plan. Each year, it runs from the Monday of the second full work week in November through the Monday of the second full work week in December.

You'll enroll through the BENEFEDS enrollment portal.

An eye exam is recommended every year. As a rule, you should not go longer than two years between eye exams. You may need to have your eyes examined more often if you have diabetes, hypertension or a family history of eye diseases, you had eye surgery, wear contact lenses, or you are taking medications that may have potential side effects on the eye.¹

Please access/register for the MyBenefits site from the home page. MyBenefits allows you to manage your benefits more easily. You may view your claims and personal information.

A vision plan is a competitively priced way to help protect the eyesight of everyone in your family. Even if you don’t wear glasses or contacts, regular visits to your eye doctor are important to your overall health.² Routine eye exams can help detect other health problems.²

You can enroll yourself for coverage in the MetLife Federal Vision Plan via online or the phone.

Online:

- Visit www.benefeds.com

- Choose Vision Coverage

- Select MetLife

Or call BENEFEDS at 1-877-888-FEDS (3337)

If you enrolled during Open Season your coverage will begin on January 1.

If you are a new hire, you can enroll within 60 days after you become eligible. Your enrollment will be effective the first day of the pay period following the one in which BENEFEDS receives and confirms your enrollment.

Whether you choose to see an in-network provider or not, using your vision coverage is simple and convenient.

• Visit Find a Vision Provider to find an in-network eye care provider who is right for you.
• Review your plan coverage before your appointment.
• At your appointment, tell them you have the MetLife Vision plan. No ID card is necessary.

That is it! MetLife will handle the rest – there are no claim forms to complete when you see an in-network provider. That is how simple it is! If you visit an out-of-network provider, you will pay the provider in full for the services and eyewear received at the time of your appointment, including taxes. Then you will submit a completed MetLife Vision claim form and itemized receipt to: MetLife Vision; PO Box 385018; Birmingham, AL 35238-5018.

No, you do not need an ID card in order to get services through your vision plan. However, printing a personalized member vision ID card is easy. Just log into MyBenefits, our secure self- service website.

You can choose the eyewear that is right for you and your budget. All in-network private practice and retail locations offer a broad range of eyewear options. From classic styles to the latest designer frames, you will find hundreds of options for you and your family.

The KidsCare℠ Plan meets the eye care and eyewear demands of active and growing children by providing two comprehensive eye exams and one pair of glasses every year, plus other important benefits.

Yes. Either contact lenses or glasses are allowed within the benefit frequency defined in your Schedule of Benefits.

MetLife does not have an in-network mail order program. If you purchase contact lenses through the mail it will be out-of-network and you will need to submit your claim and receipts to MetLife for your out-of-network reimbursement.

MetLife Vision provides members with discounts through contracted laser facilities. Discounts average 15-20% off or 5% off a promotional offer for laser vision surgery, including PRK, LASIK and Custom LASIK*. Custom LASIK coverage is only available using wavefront technology with the microkeratome surgical device. Other LASIK procedures may be performed at an additional cost to the member. Laser vision care discounts are only available from in-network contracted facilities.

You can choose the eyewear that’s right for you and your budget. Your eye care professional can help you choose from classic styles to the latest designer frames. You can select from hundreds of options for you and your family. Some of the great brands to choose from include Anne Klein, bebe^®, Flexon^®, Lacoste, Nike, Nine West, Calvin Klein, and more.

Yes. Your MetLife Vision benefits allow you to get an eye examination from one provider and your glasses or contact lenses from another. You will need to check with your provider to see what their policy is for filling another doctor’s prescription. However, please note, under this plan, only one lens benefit (either glasses or contact lenses) is allowed per frequency.

With the SunCare Plan, you can use your frame allowance for non-prescription sunglasses. A pair of sunglasses can protect your eyes from the harmful ultraviolet (UV) rays which can damage your cornea and result in UV-related illnesses such as cataracts, cancer of the eyelids, pteryguim (tissue build-up on the whites of the eyes) and macular degeneration.

Yes. The Vision plan includes discounts on additional services from participating private practice providers, including 20% off complete pairs of prescription eyeglasses and sunglasses. Go to our secure member website to view the full details of the additional discounts available.

Yes. You can use your Flexible Spending Account (FSA) to pay for a variety of health-related out-of pocket expenses, including those associated with ancillary benefits like vision benefits under this plan. Money from the FSA can be applied toward the eye exam copay and toward out-of-pocket costs for prescription glasses or contact lenses (including upgrades). Employees can even use FSA funds for laser vision correction.

No. Eligible family members include your spouse and unmarried dependent children under age 22 for dependents of federal civilian employees and age 21 (23 if full-time student) for dependents of military retirees.

With this plan, you have access to thousands of private practice optometrists, ophthalmologists and opticians — credentialed according to National Committee of Quality Assurance (NCQA) standards — as well as top retail optical providers, like Costco Optical, Visionworks, and more. You have the convenience to choose based upon your needs and preferences at the time of service. To locate a MetLife Vision network provider 24 hours a day, seven days a week, go to Find a Vision Provider or call MetLife Vision at 1-800-988-8333 for access to our 24/7 Interactive Voice Response system. Prior to enrollment, you may visit Find a Vision Provider to locate a MetLife vision network provider near you.

No. You can visit any licensed vision provider. However, your out-of-pocket costs are usually lower when you visit an in-network provider.³

No, you and your dependents each have the freedom to choose any provider.

Yes. The MetLife Vision provider network includes highly skilled and professionally certified optometrists and ophthalmologists. Whether your participating MetLife Vision provider is an optometrist or ophthalmologist, you will receive a comprehensive vision exam and you can purchase glasses and contacts in their office.

While we do not have an international vision provider network, we do offer reimbursements for services obtained overseas. Please see the Plan Details page for the reimbursement schedule.

Not if you visit a network provider. You do not need to file claims if you stay in-network for care. The network provider will confirm your eligibility, submit the claim and calculate your out of pocket costs, if any, at the time of service. If you visit an out-of-network provider, you pay the provider in full for the services and eyewear received at the time of your appointment, including taxes. Then you submit a completed MetLife Vision claim form and itemized receipt to:

MetLife Vision;
PO Box 385018;
Birmingham, AL 35238-5018.

Claim forms are available on MyBenefits site or by calling Customer Service 1-800-988-8333.

If you used your benefits at an in-network provider, you do not need to check the status of a claim, as we will work with the provider directly. If you filed an out-of-network claim, simply visit MyBenefits, our secure member website to check your claim history.

If you have vision coverage through your Federal Employee Health Benefits (FEHB) plan and coverage under FEDVIP, your FEHB plan will be the first payor of any benefit payments. When services are rendered by a vision care provider who participates with both your FEHB and your FEDVIP plan, the FEDVIP plan allowance will be the prevailing charge, in these cases. We are responsible for facilitating the process with the primary FEHB payor. You are responsible for the difference between the FEHB and FEDVIP benefit payments and the FEDVIP plan allowance. Please see the 2021 MetLife FEDVIP Vision Plan Brochure for examples.

Yes. You are free to make an FSA election amount during your annual open season to use for qualified health and medical expenses.

The FSAFEDS can be contacted at 1-877-FSAFEDS (1-877-372-3337), TTY: 866-353-8058 or at http://www.fsafeds.com.

Yes.

Yes.

You can download an FSAFEDS claim form at www.FSAFEDS.com or click on the following link: https://www.fsafeds.com/public/pdf/FSAFEDS-HCFSA-Claim-Form.pdf. Instructions on how to submit the claim, including submission methods, are included.

Please refer to date shown on your vision explanation of benefits (EOB) to review your claim and to determine when MetLife processed your claim. You can review/ download your vision EOB from the MetLife MyBenefits site. Please contact FSAFEDS for further details about qualified expenses.

You can submit your FSA claims by toll free fax to 1-866-643-2245 or to 1-502-267-2233 or by mail to:

FSAFEDS Program
PO Box 14127
Lexington, KY 40512-4127

You are free to contact FSAFEDS at 1-877-FSAFEDS (1-877-372-3337), TTY: 866-353-8058 or at http://www.fsafeds.com.

A member or former member of the uniformed services entitled to retired, retainer, or equivalent pay and other benefits based on duty in the uniformed services or retired due to medical disability as determined by the U.S. Department of Defense. This includes Retired Reserve members who are age 60 and older and under age 60 (gray area reservists) not yet receiving retired pay.

A spouse, eligible child, or eligible dependent of a retired uniformed service member (sponsor) or Retired Reserve member (sponsor) who meets one of the following vision exceptions:

• the sponsor is receiving Veterans Affairs (VA) vision services
• the sponsor has vision insurance through his or her employer that doesn't cover family members
• the sponsor is unable to receive vision services due to a medical or vision condition

To see if you or a dependent are eligible to enroll you can visit BENEFEDS.com to confirm eligibility.

The following family members are typically eligible for enrollment in a FEDVIP vision plan under the sponsor's or certifying family member's coverage as dependents.

1. A spouse of an eligible member of the uniformed services (sponsor)

2. A child of an eligible member of the uniformed services: The child must be:

• under age 21 (non-student);
• under age 23 (full-time student)*; or
• incapable of self-support because of a mental or physical incapacity before age 21 (non-student) or age 23 (full-time student)**

A child's status as a student or of being incapable of self-support must be registered in the Defense Enrollment Eligibility Reporting System (DEERS).

3. A dependent of an eligible member of the uniformed services who is in legal custody of the sponsor for more than 12 months (including pre-adoptive children and eligible wards of state): The dependent must be:

• under age 21 (non-student);
• under age 23 (full-time student)*; or
• incapable of self-support because of a mental or physical incapacity before age 21 (non-student) or age 23 (full-time student)**

A dependent's status as a student or of being incapable of self-support must be registered in the Defense Enrollment Eligibility Reporting System (DEERS).

*A full-time student is an unmarried child or dependent who is enrolled full-time at an accredited educational institution and whose sponsor is providing at least 50% of his or her financial support while enrolled. Children and dependents who are full-time students are eligible for FEDVIP coverage until their 23rd birthday or graduation (whichever is first).

**An unmarried child or dependent incapable of self-support because of a mental or physical incapacity before age 21 (non-student) or age 23 (full-time student) must be financially dependent on the sponsor for more than 50% of his or her support.

If you're newly eligible for FEDVIP, you have 60 days from the date you became eligible to enroll in a FEDVIP vision plan.

Qualifying life events (QLEs) are certain life events that allow you to enroll in the Federal Employees Dental and Vision Insurance Program (FEDVIP), or make changes to your existing FEDVIP plan, outside of open season.

The QLEs for FEDVIP may differ from QLEs for other Federal benefits programs such as the Federal Employees Health Benefits (FEHB) program. Each program has its own law and regulations.

The time frame for requesting a QLE change is from 31 days before to 60 days after the event. You cannot request a new enrollment based on a QLE before the QLE occurs, with limited exceptions.

To see if you or a dependent are eligible to enroll you can visit BENEFEDS.com to confirm eligibility. You will be asked a few questions to determine what QLE you experienced and if it allows you or a dependent to enroll outside of Open Season.

Examples of FEDVIP QLEs that allow you to enroll outside of Open Season include:

• You got married.
• You lost your other vision coverage.
• Your military pay, or Federal annuity or compensation was restored.

For a list of all the FEDVIP QLEs, visit the Qualifying Life Events section of BENEFEDS.com, found in the Education and Support tab of the site.

If you recently retired from the uniformed services, you are now newly eligible to enroll in FEDVIP vision coverage, but it is not considered a QLE. You are considered newly eligible for the program and have 60 days from the date you became eligible to enroll in a FEDVIP vision plan. If you miss your 60-day enrollment period, then you must wait until the next open season.

If you are already retired from the uniformed services and you are now leaving or retiring from private sector employment, you can enroll in FEDVIP if you experienced a FEDVIP qualifying life event (QLE). For instance, if you lost insurance as part of leaving the private sector, then you are eligible to enroll in FEDVIP within 31 days prior to and 60 days after the date of the QLE. However, if you are only canceling insurance with your employer but it is still available to you, then you must wait until the next open season to enroll.