We are currently offering a Preferred Provider Organization (PPO) program nationwide as an individual dental insurance policy. A Dental HMO/Managed Care program is available to residents of Florida and Texas. Dental HMO/Managed Care will be available at a future date to residents of California and New York.
1. MetLife Preferred Dentist Program is a Dental Preferred Provider Organization (PPO) program. You can choose from thousands of participating general dentists and specialists nationwide. Plus, with this program you’ll enjoy lower out-of-pocket costs for in-network services, freedom to use any dentist, and less paperwork. For more information, please go to the Dental Program Options page and enter your ZIP Code to see the programs available in your area.
2. Dental Health Maintenance Organization/Managed Care (DHMO) ) is available to individuals residing in Florida and Texas and will be available at a future date to residents of California and New York. This program is designed to help you and your family maintain oral health and reduce your out-of-pocket costs. Valuable features include over 400 covered services, no deductibles and no claim forms, and a broad network of participating general dentists and specialists. For more information, please go to the Dental Program Options page and enter your ZIP Code to see the programs available in your area.
A participating dentist is a general dentist or specialist who has agreed to accept negotiated fees* as payment in full for covered services. Negotiated fees typically range from 30% - 45% less than the average charges in a dentist’s community for similar services.
*Negotiated fees refer to the fees that in-network dentists have agreed to accept as payment in full for covered services, subject to any copayments, deductibles, coinsurance and benefit maximums. Negotiated fees are subject to change.
You can use any licensed dentist. However, if you visit an out-of-network dentist you may have higher out-of-pocket costs than if you use a dentist that is in-network. In most states, the TakeAlong Dental programs have maximum allowable charges that in-network providers have agreed to accept as payment in full for covered services*. We pay a percentage (% varies by type of procedure) of those agreed upon charges, and you are responsible for the remaining balance of those charges. In most states, out-of-network benefits are also based on a percentage of the maximum allowable charge. If you visit an out-of-network dentist, in addition to any applicable deductible, you would be responsible for the percentage of the maximum allowable charge that MetLife does not pay (the coinsurance amount) as well as for the amount of the out-of-network dentist’s fee that is in excess of the maximum allowable charge.
* Maximum allowable charges refer to the charges that in-network dentists have agreed to accept as payment in full for covered services, subject to any deductibles, copayments, coinsurance and benefit maximums. Maximum allowable charges are subject to change. In most states, out-of-network benefits are also based on a percentage of the maximum allowable charge.
If your dentist does not participate in our network, and you would like to encourage him or her to apply, ask your dentist to visit www.metdental.com, or call 1-866-PDP-NTWK for an application. The website and phone number are for use by dental professionals only.
A pretreatment estimate is requested before you get care. Your general dentist or specialist sends MetLife a plan for your care and asks for an estimate of benefits. We recommend that you or your dentist request a pretreatment estimate for any service(s) that may cost more than $300. This often applies to services such as crowns, bridges, inlays and periodontics.
To get an estimate, simply ask your dentist to submit a request online at www.metdental.com or call 1-877-MET-DDS9 (638-3379). You and your dentist will receive a benefit estimate — online or by fax — for most procedures while you are still in the office. Actual payments may vary depending upon plan maximums, deductibles, frequency limits and other conditions at time of payment.
Dentists may submit your claims for you, which means you have little or no paperwork. You may also download a Dental Claim form. Just fill out the participant portion and have your dentist complete the rest. Either you or your dentist can submit the form, and benefits are paid to you, unless you have arranged for them to go directly to your dentist. Your completed claim form should be mailed to MetLife Dental Claims, PO Box 981282, El Paso, TX 79998-1282. You can also fax your form to 1-859-389-6505.
You are able to track your claims online at http://online.metlife.com and even receive email alerts when a claim has been processed. Once your claim is processed, you will receive an Explanation of Benefits statement.
This Dental HMO/Managed Care program is designed to support you in maintaining and improving your oral health, providing coverage on hundreds of procedures. There are no deductibles or annual maximum, making it easier for you to receive the preventive care you need to help avoid more costly procedures.
Depending on your program, you may pay for dental care in one of two ways:
Copay: You pay a set dollar amount (copayment) associated with each covered procedure at the time of service.
Coinsurance: At the time of service, you are only responsible for the difference between the dentist’s contracted fee and the amount covered (“covered percentage”) for each covered procedure. For example, if fillings are covered at 90%, and the dentist’s contracted fee for this service is $100, your out-of-pocket cost will be $10.
For a full list of covered services including information on any limitations and additional charges for certain procedures as well as what is not covered by the program, please refer to the Schedule of Benefits located on the Dental Program Options page. You will need to enter your zip code to view the programs available in your area. Or you may find the program information in the printed enrollment material.
This is a “self referral” program and if your selected participating dentist determines that you need the services of a specialty care provider*, you may call a participating specialist directly. With this program, you will save 25% off the provider’s usual and customary fee. You can select a specialty care provider at Find a Dentist or by contacting Customer Service through the Customer Support section on this website.
*In California, orthodontic and pedodontic specialty services require pre-approval. Your selected participating dentist will contact MetLife or its affiliate for pre-approval. Once approved, your dentist will contact you with the name of a participating specialist.
If your dentist does not participate in our network, and you would like to encourage him or her to apply, ask your dentist to visit www.metdental.com for an application. The website is for use by dental professionals only.