Ø
Is
the Dental Plan available outside of the United States or
Canada?
With MetLife, you receive benefits whether or not you and/or each eligible dependent visit a participating dentist. But, when you visit a participating dentist, you have the opportunity to maximize your benefit plan with access to lower, out-of-pocket expenses. The MetLife program is a Preferred Provider Organization, wherein you choose the dentist at the time of treatment. You do not have to pre-select a primary dentist nor do you need an ID card or referrals for specialty care.
You can conduct online provider searches (with direction and mapping capabilities) via MetLife’s Dental Internet site at www.metlife.com/dental. You can also call 1-800-942-0854.
No, you and your dependents each have the freedom to choose any dentist, in and out-of-network, at any time.
No, you do not need to present an ID card to prove coverage or confirm that you’re eligible. Your dentist can easily verify eligibility and plan information by phone or online.
Single coverage is $19.35
Single + one is $38.44
Family is $72.53
The monthly cost will be deducted from your pay. By taking the monthly premium out through the Flex Plan you will save money on your taxes.
You may not change your mind after the Plan year begins. You can, however, decide not to participate the following year, but your premium deduction will continue throughout the Plan year.
There are certain circumstances allowing you to change your participation. A change in status would be a qualifying event; this would permit you to change your Dental participation. A qualifying event is:
q “Change of health insurance coverage” – (spouse loses coverage)
q “Change of family status: - (a birth or adoption of a child, a death, marriage, or divorce)
A change in status must be reported to the Department of Human Resources within 30 days of the event. You will need to include documentation to support the qualifying event.
Yes, the maximum benefit per person is $750.00 for each calendar year.
No.
No, the MetLife Plan does not cover Orthodontia. However, the MetLife Preferred Dentist Program can still provide you with savings. If you visit a participating PDP orthodontist you will receive a special negotiated price. Even though the plan may not cover orthodontia, you and your family can still take advantage of valuable savings by using a participating orthodontist. Also, if you can plan for this expense, you can set money aside in the Flex Plan for additional tax savings.
The co-pays apply to Type B Services only; there are no co-pays for Type A Services at Network providers. In network or out, the co-pays are the same and apply to each visit. Individual co-pays are $25.00 and Family, $75.00.
In addition, at a Network provider, Type A Services will be covered at 100% and Type B Services will be covered at 90%.
Below is a list of Type A Services that will be covered at 100% by using a Network provider.
To view or print a copy of the Benefit Plan
Below is a list of Type B Services that will be covered at 90% after co-pay by using a Network provider.
The MetLife does NOT cover NEW Crowns, Dentures, Inlays, Onlays, or Bridgework.
To view or print a copy of the Benefit Plan
The MetLife Plan will not cover the following:
To view or print a copy of the Benefit Plan
By using a Network provider for Type A Services you will not have any out-of-pocket expenses. However, going outside the MetLife Network you will have expenses. Those expenses will vary based on the services you receive.
Using a Network provider for Type B Services will be paid at 90% after the co-pay. However, going outside the MetLife Network you will have additional expenses. Those expenses will vary based on the services you receive.
Please view the MetLife Benefit Plan for more information.
No, services are only available within the United States and Canada. No claims for services outside of this area will be paid.