What Does MetLife Cover?

MetLife’s supplemental insurance helps bridge the gaps in your primary health coverage by providing cash benefits for unexpected medical events, such as accidents, hospital stays, or critical illnesses. These plans pay you directly, allowing flexibility to cover expenses like deductibles, copays, household bills, or childcare. Explore our 2025 offerings, including updated benefits, potential payouts, and plan comparisons to select the right protection for you and your family.

MetLife Chiropractic Coverage

MetLife accident insurance covers chiropractic treatments for accident-related injuries, paying benefits for visits within a specified period post-incident. Typical payouts range from $25-$50 per visit, up to a maximum of 10 visits per accident, depending on the plan. Coverage helps with structural adjustments following accidents like falls or strains, aiding in pain relief and recovery without out-of-pocket strain. This benefit is particularly useful for soft tissue injuries, ensuring you can access non-invasive care promptly.

Does MetLife Cover Braces?

MetLife dental plans, such as PPO or FEDVIP, provide orthodontia coverage, especially for children under 19. Reimbursement is typically 50% after deductible, with lifetime maximums of $1,000-$2,000. No waiting periods for major services in many plans. This can significantly reduce costs for orthodontic needs, making braces more accessible for families. Coverage includes adjustments and retainers, supporting long-term dental health.

How Much Does MetLife Pay for Surgery?

Under hospital indemnity, MetLife pays lump sums for surgeries, ranging from $500-$5,000 based on procedure complexity. For example, outpatient surgery may pay $500, while major inpatient procedures pay higher. Critical illness adds lump sums if surgery relates to covered conditions. These payments are made directly to you, helping cover surgical fees, anesthesia, or related travel expenses not handled by primary insurance. Always verify specific procedures in your policy schedule.

MetLife Pregnancy Payout

Hospital indemnity covers maternity hospital stays, with benefits for admission and confinement. Typical payouts: $1,000-$2,000 for admission, plus $100-$200 per day. Short-term disability may cover maternity leave, replacing 60% of income for 6-8 weeks post-delivery. This supports new parents by easing financial burdens during this joyful but expensive time, including coverage for complications of pregnancy like ectopic pregnancies.

Pregnancy Event Payout (Example)
Vaginal Delivery Admission $1,000
Cesarean Delivery Admission $1,500

MetLife Herniated Disc Coverage

Accident insurance covers treatment if injury-related, with payouts for surgery ($500-$2,000) or therapy. Hospital indemnity adds if hospitalization occurs. This coverage is crucial for sudden back issues from accidents, providing funds for medical interventions and rehabilitation. It specifically addresses ruptured discs requiring surgical repair, excluding bulging discs.

Procedure Basic Enhanced
Ruptured Disc Surgery $500 $1,000

MetLife Accident Insurance Payout

Covers 24/7 for injuries on or off the job, including ER visits, surgeries, and follow-up care. Benefits help with deductibles and copays. This plan is designed for unpredictable events, offering peace of mind for active lifestyles. Payouts are lump-sum, usable for any purpose, from medical bills to lost wages.

Example:

A sports injury requiring ER and surgery might pay $2,000 total ($1,000 treatment, $1,000 hospital). The cash can be used flexibly for any needs arising from the accident.

Does MetLife Pay for Sprains?

Yes, accident insurance covers sprains with benefits for treatment, such as $100-$300 for minor injuries, plus physical therapy if needed. Sprains from twists or falls are common, and this payout helps cover doctor visits, braces, or rehab sessions promptly. Coverage extends to related hospital or therapy costs.

MetLife Cancer Insurance

Provides lump-sum payments upon diagnosis, plus benefits for treatments like chemo. Expanding in 2025 with Cancer Support Benefit. This specialized coverage focuses on the high costs of cancer care, including experimental treatments or travel to specialists. Recurrence benefits may apply after 6 months.

Example:

Cancer diagnosis could yield $10,000-$50,000 lump sum, plus ongoing treatment benefits, alleviating financial toxicity during treatment.

MetLife Serious Illness Insurance

Critical illness insurance pays lump sums for heart attacks, strokes, etc., usable for any expenses. It acts as a financial safety net for life-altering diagnoses, with multiple payouts possible up to three times the initial benefit for recurrences.

Example:

Heart attack might pay $10,000-$30,000, covering recovery costs like home modifications or lost income.

MetLife Life Insurance

Offers term, whole, and universal life, with accidental death riders adding extra payouts (e.g., double benefit for accidents). Example: $100,000 policy with accidental death could pay $200,000. This ensures beneficiaries are protected, with options for payroll deduction for convenience and guarantee issue limits up to $500,000.

MetLife Stitches Coverage

Accident insurance pays for lacerations requiring stitches, based on length. Payments are quick, helping with ER bills immediately. Coverage applies within 120 days of the accident for qualifying treatments.

Laceration (Within 72 Hours) Basic Enhanced
Less than 2″ $50 $100
2″ to 6″ $200 $400
More than 6″ $400 $800
No Stitches $25 $50

MetLife Crutches Coverage

Accident insurance includes benefits for mobility aids like crutches, typically $100-$200. This aids recovery from leg injuries by covering equipment costs. Durable medical equipment benefits extend to wheelchairs and braces as well.

Equipment Payout
Crutches $150

MetLife Short-Term Disability Payout

Replaces 60-70% of income for up to 26 weeks, with elimination periods of 7-14 days. Ideal for temporary illnesses or injuries preventing work, including maternity leave. Benefits coordinate with other income sources for comprehensive support.

Benefit Details
Weekly Benefit 60-70% of earnings
Duration Up to 26 weeks
Elimination Periods 7/14 days

MetLife Chiropractic Visits Payout

Pays per visit for accident-related care. Helps manage ongoing pain from injuries. Up to 10 visits covered, focusing on rehabilitation after accidents.

Visit Type Payout
Initial Visit $50
Follow-up Visits $25 each

MetLife Blood Work Coverage

Wellness benefits may cover preventive blood tests, up to $100 annually. Encourages regular health checks for early detection. Part of the health screening benefit, reimbursing eligible tests like cholesterol or diabetes screenings.

Treatment Payout
Blood Tests Up to $100

MetLife Torn Rotator Cuff Coverage

Accident insurance pays for surgical repair, typically $500-$1,500. Supports shoulder injury recovery from sports or falls. Includes therapy benefits post-surgery for full rehabilitation.

Treatment Payout
Surgical Treatment $1,000

MetLife Hysterectomy Coverage

Hospital indemnity pays for admission and confinement; critical illness if related to cancer. Covers major procedures with cash benefits. Includes daily confinement payouts during recovery.

Procedure Payout
Hysterectomy Admission $1,000

MetLife Broken Tooth Coverage

Dental plans cover repairs like crowns (50-80% reimbursement) or extractions. Essential for accidental dental damage. Accident insurance may add lump-sum for ER treatment.

Treatment Reimbursement
Crown Repair 50-80%
Extraction 50-80%

MetLife Anesthesia Coverage

Included in surgery benefits under hospital indemnity, with additional payouts if applicable. Reduces costs for procedures requiring sedation. Often bundled with surgical indemnity benefits.

Procedure Payout
Surgical Anesthesia $200-$500

Does MetLife Work with Medicaid?

Yes, supplemental plans complement Medicaid by covering non-medical costs during illnesses or accidents. They fill gaps where Medicaid may not cover extras like travel or lost wages. Ideal for low-income families seeking additional protection.

MetLife Health Insurance Offerings

  • Accident Insurance: Covers injuries.
  • Hospital Indemnity: Pays for stays.
  • Critical Illness: Lump sums for diagnoses.
  • Cancer: Treatment benefits.

MetLife Back Injury Coverage

Accident insurance covers equipment and treatment for back injuries. Provides support for common workplace or accidental strains, including therapy and braces. Benefits extend to related hospitalizations.

Equipment Payout
Wheelchair $300
Back Brace $200
Walker $100

MetLife Group Accident Insurance Payout

Family coverage for accidents, with benefits for treatment and hospital. Extends protection to spouses and children. Includes accidental death and dismemberment up to policy limits.

Emergency Treatment Benefit

Pays $100-$200 for ER within 24 hours.

Hospital Benefits Member Spouse Child
Hospital Admission $1,000 $1,000 $1,000
Hospital Confinement (Per Day) $200 $200 $200
ICU (Per Day) $400 $400 $400

Is MetLife Group Accident Insurance Worth It?

For active families or risky jobs, it provides essential coverage for unexpected costs, making it a valuable addition to primary insurance. The low premiums often outweigh potential out-of-pocket expenses in accidents, with 58% of Americans worried about medical bills.

MetLife Dental Insurance

Covers preventive (100%), basic, and major services with 35-50% savings in-network. Promotes oral health with no or low deductibles. PDP Plus network offers thousands of providers nationwide.

Procedure Reimbursement
Preventive Care 100%
Basic Treatment 80%
Major Treatment 50%

MetLife Vision Insurance

Covers exams (100% in-network), eyewear with up to 60% savings. Includes discounts on LASIK for clearer vision options. Partners with VSP for broad network access.

Service Reimbursement
Eye Exam 100%
Glasses/Contacts Up to 60% savings
Eye Surgery (LASIK Discount) Discounted

MetLife Wellness Benefit

Critical illness plans offer up to $100 annually for screenings like mammograms or blood tests. Incentivizes preventive care to catch issues early. Covers over 50 health screenings, including immunizations and hearing tests.

MetLife Diabetes Coverage

Critical illness may pay lump sums for complications like hospitalizations, up to $5,000-$20,000 depending on severity. Helps manage chronic condition flares. Listed as a covered condition at 25% of initial benefit.

MetLife Heart Attack Coverage

Critical illness insurance provides a full lump-sum benefit upon diagnosis, up to $30,000, with recurrence benefits after 6 months. Covers angioplasty and related treatments. Use funds for rehab, medications, or daily expenses during recovery.

MetLife Stroke Coverage

Pays 100% of initial benefit for ischemic or hemorrhagic stroke, with potential for multiple payouts up to total benefit limit. Supports therapy and home care costs. Diagnosis requires neurological deficit lasting over 24 hours.

MetLife Burns Coverage

Accident insurance pays based on degree and body surface area, up to $10,000 for third-degree burns over 20%. Includes skin grafts and hospital stays. Essential for severe injury recovery, covering prosthetics if needed.

MetLife Concussion Coverage

Provides $200-$500 for diagnosis and treatment following an accident, plus ER benefits. Covers follow-up CT scans and therapy. Helps with cognitive rehab for sports or fall-related incidents.

MetLife Fracture Coverage

Lump-sum for broken bones, $100-$1,000 per fracture based on type (e.g., hip higher than finger). Chip fractures at 25%. Paid once per accident, aiding cast, surgery, or rehab costs.

MetLife Dislocation Coverage

Pays $200-$2,000 for joint dislocations like shoulder or knee, with partial for reductions. Covers relocation procedures. Partial dislocations at 25%, supporting immediate medical needs.

Plan Comparison

Compare features to find the best fit for your needs.

Feature Basic Enhanced
Hospital Admission $1,000 $2,000
Surgery Benefit $500-$2,000 $1,000-$5,000
Accident Treatment Up to $1,000 Up to $3,000
Wellness Benefit $50 $100

Frequently Asked Questions

How do I file a claim with MetLife?

File online via MyBenefits portal or app; claims processed in 10 business days. Provide documentation like bills or diagnosis reports for swift approval. Phone claims available at 1-800-GET-MET8.

Does MetLife cover pre-existing conditions?

Some plans have no waiting periods, but others may exclude pre-existing for 6-12 months. Review policy disclosures carefully, especially for critical illness.

How do I renew my MetLife policy?

Contact your employer or MetLife at 1-800-GET-MET8. Automatic renewals available for group plans, with annual rate adjustments based on age.

Customer Testimonials

Sarah L., Office Worker:

“MetLife’s accident insurance paid $2,500 for my daughter’s sports injury, covering ER and follow-up quickly.”

John M., Manager:

“After a critical illness, MetLife’s lump-sum payment of $20,000 helped with bills during recovery.”