Covered services are grouped into three categories: Preventive (Type A); Basic (Type B); and Major (Type C). There are two coverage types, “Preferred” and “Preferred Plus,” which determine if services are considered Preventative, Basic or Major. Both coverage types have multiple coinsurance, annual maximum, deductible and orthodontia options. (This coverage can be purchased on a stand-alone basis for groups with 10 or more employees.) Note: There is no waiting period for major service for groups with no prior dental coverage.

What's available:

• Coverage Types to Choose From
  • Preferred
  • Preferred Plus
• Benefit Percentage to Choose From
  • Option 1
    • In Network Benefits
      • Type A: 50% of PDP Fee
      • Type B: 50% of PDP Fee
      • Type C: 50% of PDP Fee
    • Out-of-Network Benefits
      • Type A: 50% of R&C
      • Type B: 50% of R&C
      • Type C: 50% of R&C
  • Option 2
    • In Network Benefits
      • Type A: 100% of PDP Fee
      • Type B: 80% of PDP Fee
      • Type C: 50% of PDP Fee
    • Out-of-Network Benefits
      • Type A: 100% of R&C
      • Type B: 80% of R&C
      • Type C: 50% of R&C
  • Option 3
    • In Network Benefits
      • Type A: 100% of PDP Fee
      • Type B: 90% of PDP Fee
      • Type C: 60% of PDP Fee
    • Out-of-Network Benefits
      • Type A: 100% of R&C
      • Type B: 80% of R&C
      • Type C: 50% of R&C
• Deductibles
  • $0, $25, $50, $75 and $100
• Calendar Year Maximums
  • $750, $1,000 and $1,500

PDP Fee Schedule: When benefit reimbursement is limited to the PDP (Preferred Dentist Program) fee schedule, it means that benefits are paid based on the negotiated PDP fee. A negotiated fee refers to the PDP fee schedule which participating dentists agree to accept as payment in full, subject to deductibles, cost-sharing and benefit maximums. Reimbursement for a service may be based on all or part of the PDP fee. Reimbursement depends on the plan chosen and the service rendered.

R&C: Out-of-network benefit reimbursement is limited to the R&C (Reasonable and Customary) charge. That means that benefits are paid based on the R&C charge for a particular service, determined for the area where the service was rendered. The R&C charge 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 usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife. Reimbursement may be based on all or part of the R&C fee. Reimbursement depends on the service rendered.

Special Features:

Orthodontia Option — When selected, orthodontia coverage is included for dependent children up to age 19 for groups with 15 or more lives. Groups with current orthodontia in force with at least 10 lives are also eligible to choose the orthodontia option.

Freedom of Choice — All MetLife plans give participants the freedom to choose any dentist – even if that dentist does not participate in MetLife’s Preferred Dentist Program (PDP).

Preferred Dentist Program (PDP) — MetLife is the largest administrator of dental benefit plans among all single commercial carriers,¹ providing dental plan administration for over 21 million people.² MetLife’s has over 187,000 participating dentist locations³ and 4,647 in Michigan³. To find out if a dentist participates in the PDP or to obtain a list of participating dentists go to www.metlife.com/dental or call 1-800-ASK-4-MET (1-800-275-4638). 

1. 2011 MetLife Market Research, based on enrolled lives as of 12/31/11
2. MetLife data as of May 2010
3. MetLife data as of July 2012  

For more information, please contact Insurance & Benefits at 800-842-6513.