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Dental Insurance
Customer Service for PPO Plans (Low & High)1-800-942-0854Customer Service for DHMO Plan1-800-880-1800There are three dental plans offered:- Dental Health Managed Organization (DHMO or HMO)
- Preferred Provider Organization (PPO) – High Option
- Preferred Provider Organization (PPO) – Low Option
Learn more about Dental Plans: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
RATE PER PAYCHECK
Employee
$10.75
Employee + 1
$18.81
Family
$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 (up to age 19)
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
RATE PER PAYCHECK
Employee
$25.96
Employee + 1
$45.38
Employee + Family
$70.79
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 (up to age 19)
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
COVERAGE
RATE PER PAYCHECK
Employee
$11.55
Employee + 1
$20.18
Employee + Family
$31.49
This is a voluntary benefit and the premiums are paid by the employee, if coverage is elected.
Permissible Benefit Enrollment Event: For midyear changes, review the Permissible Benefit Enrollment Event guidelines and process.Dependent EligibilitySpouse - An individual to whom you are legally married.Children - Your eligible child or stepchild to age 30 (coverage continues to the end of the calendar year of their 30th birthdate).