• Dental Insurance - MetLife

     
     
    metlife
     
     
     
     
     
     
     
     
    Customer Service for PPO Plans (Low & High)
    1-800-942-0854
     
    Customer Service for DHMO Plan
    1-800-880-1800 
     
     
     
    There are three dental plans offered:
     
    • Dental Health Managed Organization (DHMO or HMO)
    • Preferred Provider Organization (PPO) – High Option
    • Preferred Provider Organization (PPO) – Low Option
      
     
    Find a Dental Provider:
     
    • Go to www.metlife.com
    • Select "Find a Dentist"
    • Choose your network
      • Select PDP Plus for PPO High/Low and enter the zip, city or state
      • Select Dental HMO/Managed Care for DHMO and enter the zip, city or state
        • Select your plan "MET185A" and click GO

    HMO Plan Details:

    • Dental Health Managed Organization (DHMO or HMO)
    • Employee selects an in-network dentist. Family members are not required to choose the same dentist as the employee; however the dentist must be in-network
    • Employee must pre-select an in-network dentist and call MetLife at 1-800-880-1800 to assign the dentist before receiving dental services
    • No pre-existing condition limitations, no limit on benefits or fixed schedule of co-payments

     

    DHMO PLAN

    Office Visits

    $5

    Routine Cleanings

    No charge/2 per year

    X-rays

    No charge

    Fillings (amalgam/silver)

    No charge

    Orthodontia (treatment up to 24 mo)

    $1695

      

    DHMO RATES 

    COVERAGE

    2019 RATES PER PAYCHECK 

    2020 RATES PER PAYCHECK

    Employee

    $10.23

    $10.75

    Employee + 1

    $17.90

    $18.81

    Family

    $28.13

    $29.55

    This is a voluntary benefit and the premiums are paid by the employee, if coverage is elected.

     

     

    PPO Dental Plan Options & Details:

     

    • Preferred Provider Organization (PPO)
    • Provides the choice of going to an in-network dentist or an out-of-network dentist. Widest network of dentists available
    • Higher out-of-pocket costs, but greater flexibility in seeking care

     

    PPO HIGH

     

    In-Network

    Out-of-Network

    Calendar Year Annual Deductible

     

    Individual

    $50

    $50

    Family

    $150

    $150

    Type A – PreventativeServices

    (Oral exams, bitewing x-rays, cleanings)

    100% of PDP Fee*

    (No Deductible)

    80% of PDP Fee*

    (No Deductible)

    Type B - Basic/GeneralServices

    (Fillings, full mouth x-rays ,periodontal)

    80%

    (After Deductible)

    60%

    (After Deductible)

    Type C - Major Services

    (Extractions, bridges,crowns, dentures)

    50%

    (after Deductible)

    40%

    (after Deductible)

    Orthodontia Lifetime Maximum Benefit

    50% of PDP Fee up to $1,000 per person

    Calendar Year MaximumBenefit

    $5,000 per person

    *PDP Fee (Preferred Dental Program) refers to the fees that participating dentists have agreed to accept as full payment subject to co-payments, deductibles, cost sharing and plan benefit maximums.

     
     

    PPO HIGH RATES

    COVERAGE

    2019 RATES PER PAYCHECK

    2020 RATES PER PAYCHECK

    Employee

    $24.13

    $25.36

    Employee + 1

    $42.19

    $44.33

    Employee + Family

    $65.82

    $69.14

    This is a voluntary benefit and the premiums are paid by the employee, if coverage is elected.

     
     

    PPO LOW

     

    In-Network

    Out-of-Network

    Calendar Year Annual Deductible

     

    Individual

    $100

    $100

    Family

    $300

    $300

    Type A – PreventativeServices

    (Oral exams, bitewing x-rays, cleanings)

    80% of PDP Fee*

    (No Deductible)

    60% of PDP Fee*

    (No Deductible)

    Type B - Basic/GeneralServices

    (Fillings, full mouth x-rays ,periodontal)

    55%

    (after Deductible)

    40%

    (after Deductible)

    Type C - Major Services

    (Extractions, bridges,crowns, dentures)

    30%

    (after Deductible)

    30%

    (after Deductible)

    Orthodontia Lifetime Maximum Benefit

    45% In-Network and 30% Out-of-Network  of PDP Fee up to $750 per person

    Calendar Year MaximumBenefit

    $1,000 per person In-Network - $750 Out-of-Network

    *PDP Fee (Preferred Dental Program) refers to the fees that participating dentists have agreed to accept as full payment subject to copayments, deductibles, cost sharing and plan benefit maximums.

     
     

    PPO LOW RATES - 2019

    COVERAGE

    2019 RATES PER PAYCHECK

    2020 RATES PER PAYCHECK

    Employee

    $11.14

    $11.70

    Employee + 1

    $19.47

    $20.45

    Employee + Family

    $30.37

    $31.90

    This is a voluntary benefit and the premiums are paid by the employee, if coverage is elected.

     
     
    Dependent Eligibility
     
    Spouse - An individual to whom you are legally married.
    Children - Your child or stepchild to age 30 (PPO Plans); age 26 (DHMO Plan).