The information below provides a general overview of the Dental insurance options to help you make a more informed decision. Please refer to the Schedule of Benefits for complete details on each program.
|Program Features||Preferred Provider Organization (PPO)||Dental Health Maintenance Organization (HMO)/Managed Care|
|Eligibility||Available to individuals and their family members nationwide||Will only be available to residents of CA, FL, NY and TX.|
|Choice of Dentists||You have the flexibility to choose any licensed dentist, in or out of the network, and still receive cost saving benefits. Your cost may be higher when you visit an out-of-network dentist.||You must pre-select a dentist, at time of enrollment, who participates in the network in order to receive benefits. Each enrolled family member may select a different participating dentist and has the ability to change dentists up to one time each month.|
|Specialty Care||No referral needed for specialty care. You may choose any specialty dentist (in- or out-of-network) and call them to make an appointment.||If your selected participating dentist determines that you need the services of a specialty care provider, you may call a participating specialist directly.2|
|Traveling within the U.S.||You have access to one of the largest network of dentists in the U.S. You have the flexibility to visit any dentist, in- or out-of-network.||Dental HMO/Managed Care programs are based on the use of defined networks; general dental care is not accessible while traveling.
The only exception is an emergency situation when you are unable to receive care from your selected participating dentist. Please refer to the Schedule of Benefits for more details.
|Network Discount||All participating dentists have agreed to accept negotiated fees as payment in full for covered services. These fees typically range from 30% - 45% less than the average charges in the same community.3||You have access to hundreds of dental services at costs that may be considerably lower than your cost would be without this program.4
You are responsible for the copayment or coinsurance for each covered service that is listed on your Schedule of Benefits, so you know what your out-of-pocket costs will be up front.
|Deductible and Annual Maximum Benefit||Typically includes a yearly deductible and an annual benefit maximum.
Please refer to the Schedule of Benefits for more specific information about the program.
|No deductibles or annual maximums|
|Participating Dentists||All participating dentists go through a rigorous and ongoing selection and review process.5|
To view more information on the programs that are available to you, enter your Zip Code on the home page.
1 In California, orthodontic and pedodontic specialty services require pre-approval. Your selected participating dentist will contact SafeGuard for pre-approval. Once approved, your dentist will contact you with the name of a participating specialist.
2 Based on internal analysis by MetLife. Savings from enrolling in a dental benefits program will depend on various factors, including the cost of the program, how often members visit a dentist and the cost of services rendered. Negotiated fees refer to the fees that participating dentists have agreed to accept as payment in full for covered services, subject to any deductibles, copayments, coinsurance and benefit maximums. Negotiated fees are subject to change.
3 Based on internal analysis by MetLife. Savings from enrolling in a dental benefits program will depend on various factors, including the cost of the program, how often members visit a participating dentist and the cost of services rendered.
4 Certain providers may participate with MetLife through an agreement that MetLife has with a vendor. Providers available through a vendor are subject to the vendor’s credentialing process and requirements, not MetLife’s. If you should have any questions, contact MetLife Customer Service.
Dental Managed Care is used to refer to product designs that may differ by state of residence of the enrollee, including but not limited to: “Specialized Health Care Services Programs” in California; “Prepaid Limited Health Service Organizations” as described in Chapter 636 of the Florida statutes in Florida; and “Single Service Health Maintenance Organizations” in Texas. Dental Managed Care program benefits are provided by Metropolitan Life Insurance Company, a New York corporation, in NY. Dental HMO program benefits are provided by: SafeGuard Health Plans, Inc., a California corporation, in CA; SafeGuard Health Plans, Inc., a Florida corporation, in FL; and SafeGuard Health Plans, Inc., a Texas corporation, in TX. The Dental HMO/Managed Care companies are part of the MetLife family of companies.
Dental benefits are provided by Metropolitan Life Insurance Company (MetLife) or an affiliate of MetLife. Certain administrative services are provided by Careington BenefitSolutions (Careington), Frisco, TX. Careington is not affiliated with MetLife or its affiliates. In certain states, availability of the individual dental product is subject to regulatory approval. Like most benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, reductions, limitations, waiting periods and terms for keeping them in force. For complete details, including any applicable exclusions and limitations, please refer to the full Schedule of Benefits or contact MetLife for more information.
MetLife Services and Solutions, LLC (MSS), New York, NY 10166SafeGuard Health Plans Inc., Irvine, CA 92614