GREATER CONFIDENCE FOR YOU. In today’s economy, how can you feel confident that your employer’s dental coverage, if any, will continue … or that if it does, it won’t become unaffordable or reduce services? The same goes for your spouse or domestic partner’s plan, if any.
- You can join over 19 million Americans who confidently enjoy comprehensive, affordable first-rate dental coverage offered by MetLife.1
- 98% of patients in MetLife Preferred Dentist Programs are satisfied with the care they received from their participating dentist.2
- 94% of plan participants are satisfied with our dental claims service.3
1MetLife data as of December, 2011
22011 MetLife Plan Participant Satisfaction Survey. Results based on participants who visited a MetLife PDP dentist and reported that they were satisfied (52%) or very satisfied (46%).
3MetLife data as of year-end 2011
GREATER SAVINGS* FOR YOU. Depending on your plan, you could save over many dental plans—and almost half of what you would pay without insurance for covered services.
- In-network fees typically are 15–45 percent less than those charged in a typical community.**
- Once your plan maximum has been met, you can get discounts on many non-covered services if they are provided by in-network dentists.***
- Your coverage begins after a calendar-year deductible of $50 per insured person, up to $150 maximum per family unit.
*Savings from enrolling in the MetLife PDP Program will depend on various factors, including how often participants visit the dentist and the costs for services received
**Based on internal analysis by MetLife.
***Negotiated fees for non-covered services may not apply in all states.
To view a Savings Example, click here.
GREATER FREEDOM FOR YOU. Although your savings will be greater if you visit a network dentist, you can continue to see your current general practitioner or specialist, even if that professional doesn’t participate in the plan.
- Your dependents are not limited to seeing only your dentists. They have the freedom to see their own, even if they are non-network network participants.
- Personalized directories can be e-mailed right to you. You also can locate a dentist, with directions and mapping capabilities, online.
- If you are not completely satisfied with the terms of your dental plan, return your certificate of insurance, without claim, within 30 days for a full and prompt refund.
GREATER BENEFITS FOR YOU. You are immediately eligible to save on preventive services such as checkups, cleanings, and bitewing x-rays.
- Basic and major restorative services are covered, including fillings, root canals and dentures.
- Your dentist can submit your claim, practically eliminating your paperwork.
- Receive an e-mail alert when a claim has been processed.
Click here to view Plan Details, Rates, List of Covered Services and Limitations.
MetLife will not pay Dental Insurance Benefits for charges incurred for:
- Services which are not Dentally Necessary, those which do not meet generally accepted standards of care for treating the particular dental condition, or which we have deem experimental in nature;
- Services for which You would not be required to pay in the absence of Dental Insurance;
- Services or supplies received by You or Your Dependent before the Dental Insurance starts for that person;
- Services which are primarily cosmetic (For residents of Texas, see notice page in your certificate);
- Services or appliances which restore or alter occlusion or vertical dimension;
- Restoration of tooth structure damaged by attrition, abrasion or erosion;
- Restoration or appliances used for the purpose of periodontal splinting;
- Counseling or instruction about oral hygiene, plaque control, nutrition and tobacco;
- Personal supplies or devices including, but not limited to: picks, toothbrushes or dental floss;
- Decoration, personalization or inscription of any tooth, device, appliance, crown, or other dental work;
- Missed appointments;
- Services covered under any workers’ compensation or occupational disease law; covered under any employer liability law; of which the employer of the person receiving such services is not required to pay; or received at a facility maintained by the Policyholder, labor union, mutual benefit association or VA hospital;
- Services covered under other coverage provided by the Policyholder;
- Temporary or provisional restorations;
- Temporary or provisional appliances;
- Prescription drugs;
- Services for which the submitted documentation indicates a poor prognosis;
- Services, to the extent such services, or benefits for such services, are available under a Government Plan. The exclusion will apply whether or not the person receiving the services is enrolled for the Government Plan. We will not exclude payment of benefits for such services if the Government Play requires that Dental Insurance under the Group Policy be paid first. Government Plan means any plan, program, or coverage which is established under the laws or regulations of any government. The term does not include: any plan, program or coverage provided by a government as an employer; or Medicare;
- The following when charged by the Dentist on a separate basis: claim form completion; infection control such as gloves, masks, and sterilization of supplies; or local anesthesia, non-intravenous conscious sedation or analgesia such as nitrous oxide;
- Caries susceptibility tests.
- Initial installation of a fixed and permanent Denture to replace one or more natural teeth which were missing before such person was insured for Dental Insurance, except for congenitally missing natural teeth;
- Other fixed Denture prosthetic services not described elsewhere in this certificate;
- Precision attachments, except when the precision attachment is related to implant prosthetics;
- Initial installation or replacement of a full or removable Denture to replace one or more natural teeth which were missing before such person was insured for Dental Insurance, except for congenitally missing natural teeth;
- Addition of teeth to a partial removable Denture to replace one or more natural teeth which were missing before such person was insured for Dental insurance, except for congenitally missing natural teeth;
- Addition of teeth to fixed and permanent Denture to replace teeth which were missing before such person was insured for Dental Insurance, except for congenitally missing natural teeth;
- Adjustment of a Denture made within 6 months after installation by the same Dentist who installed it;
- Implants included, but not limited to any related surgery, placement, restorations, maintenance, and removal;
- Repair of Implants;
- Implants supported prosthetics to replace one or more natural teeth which were missing before such person was insured for Dental Insurance, except for congenitally missing natural teeth;
- Appliances or treatment for bruxism (grinding teeth), including but not limited to occlusal guards and night guards1;
- Diagnosis and treatment of temporomandibular joint (TMJ) disorders. This exclusion does not apply to residents of Minnesota1;
- Repair or replacement of an orthodontic device1;
- Duplicate prosthetic devices or appliances;
- Replacement of a lost of stolen appliance, Cast Restoration or Denture;
- Intra and extraoral photographic images.
1 Some of these exclusions may not apply. Please see your plan design and certificate for details
Like most group dental insurance policies, MetLife group insurance policies contain exclusions, waiting periods, reductions and terms for keeping them in force. Please contact the Plan Administrator for details.
Cancellation/Termination of Benefits:
Coverage is provided under a group insurance policy (Policy Form GPN99) issued by Metropolitan Life Insurance Company. Subject to the terms of the group policy, rates are effective for one year from you plan’s effective date. Once coverage is issued, the terms of the group policy permit Metropolitan Life Insurance Company to change rates during the year in certain circumstances. Coverage terminates when your Membership in IEEE ceases, when your dental contributions cease or upon termination of the group policy by the Policyholder. The group policy may also terminate if participation requirements are not met, a dependent ceases to be a dependent or on the date of the members death, if the Policyholder fails to perform any obligations under the policy, or at MetLife’s option. There is a 30-day limit for the following services that are in progress: Completion of a prosthetic device, crown or root canal therapy after individual termination of coverage.