DENTAL

Preventative oral care can prevent unexpected costs and pain that often come with oral surgery and emergency procedures.

The dental plan is administered by MetLife. You may choose any licensed dental provider, but you benefit from discounted fees when you use network providers.

Highlights of the Plan

  • When you use a dentist participating in MetLife’s network, you are only responsible for the difference
    between the in-network fee for the service provided and the plan’s payment for the approved service.
  • When you use out-of-network providers, your cost is based on the Reasonable and Customary (R&C) cost, instead of a discounted fee. You are responsible for any amounts that exceed the R&C, in addition to the deductible and coinsurance.

For more information or to locate in-network dental providers, visit www.metlife.com/dental or call 1-800-942-0854.

Dental Plans

Benefit In-Network
You Pay 		Out-of-Network
You Pay
Deductible (Individual/Family)* $25/$75 (waived for preventive services) $25/$75 (waived for preventive services)
Annual Benefit Maximum $2,000 per person $2,000 per person
Orthodontia Lifetime Maximum $1,500 per person $1,000 per person
Type A — (cleanings, oral exams and other maintenance type procedures) 0% of PDP Fee** 0% of R&C Fee***
Type B — (fillings and other standard dental procedures) After deductible, 15% of PDP Fee** After deductible, 20% of R&C Fee***
Type C — (bridges, dentures and other complex procedures) After deductible, 35% of PDP Fee** After deductible, 40% of R&C Fee***
Type D — Orthodontia 50% of PDP Fee** 50% of R&C Fee***

* Applies only to type B & C services combined. 
** PDP Fee refers to the fees that participating PDP dentists have agreed to accept as payment in full, subject to any copayments, deductibles, cost sharing, and benefit maximums.
*** R&C Fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist’s actual charge, (2) the dentist’s usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.