Benefits

MetLife Dental Copay Plan

The MetLife Dental Copay Plan is a dental plan in which you make a copay based on a fee schedule, called the Procedure Charge Schedule. The Procedure Charge Schedule is based on the ZIP code where your dentist’s office is located. Each time you need care, you can visit any licensed dentist you choose. However, if you visit a preferred network provider, you save money since providers in the network charge lower negotiated rates. If you visit an out-of-network provider you must meet an annual deductible, you pay a higher copay and your annual maximum benefit is reduced.  You can can compare Metlife Dental Copay Plan benefits to the other dental plan to determine if it will meet your dental needs.

Your cost for the plan depends on the coverage you select.  Enrolling in the plan is limited to certain times or events during your employment.

Select benefit design features are provided below, including the copay percentage you may be asked to pay at the time dental services are rendered.  Additional information is available in the Dental Summary Plan Description.  MetLife may be contacted at 800.942.0854.

  In-network Out-of-network
Choice of Dentist Limited to MetLife Network Any licensed provider
Deductible None

Per individual: $75*

Per family: Up to $225*

Annual Maximum 

The most coverage that the Plan will provide you in one year.

Per individual: $5,000 Per individual: $1,000

Preventive Care

 

One visit in a six month period.

You pay 10%;

Plan pays 90%**

You pay 30%;

Plan pays 70%***

Basic Care

You pay 30%;

Plan pays 70%**

You pay 60%;

Plan pays 40%***

Major Care You pay 50%;

Plan pays 50%**

You pay 70%;

Plan pays 30%***

Orthodontia

(Adult and Child)

You pay 50%;

Plan pays 50%**

 

Lifetime maximum  per individual: $1,500

You pay 60%;

Plan pays 40%***

 

Lifetime maximum per individual: $500

* Waived for orthodontia

** Payment for percentage of negotiated fees as determined by MetLife, subject to cost sharing, deductible and benefit maximums.

***Payment for percentage of reasonable and customary charges as determined by MetLife. You are also responsible for 100% of any charges in excess of the reasonable and customary charge.