You have the flexibility to visit any dentist¹ — your dentist — and receive coverage under the plan. Just remember that nonparticipating dentists haven’t agreed to charge negotiated fees. That means you usually save more dental dollars when you go to a participating dentist.²

 

If you prefer to stay in the network, there are thousands of general dentists and specialists to choose from nationwide — who can meet your needs. Plus, all participating dentists go through a rigorous selection and review process.³ This way, you'll obtain professional dentist coverage without the need for referrals.

Your out-of-pocket costs are usually lower when you visit a dentist in the MetLife network. That’s because they have agreed to accept negotiated fees that are typically 30 to 45% less than average dental charges in the same community.³ This may help lower your final costs and stretch your plan maximum. Savings from enrolling in a dental benefits plan featuring the MetLife Preferred Dentist Program will depend on various factors, including the cost of the plan, how often participants visit a dentist and the cost of services rendered. Negotiated fees may even extend to non-covered services and services provided after you've reached the plan maximum. Negotiated fees refers to the fees that in-network dentists have agreed to accept as payment in full, subject to any copayments, deductibles, cost sharing and benefit maximums. Savings from enrolling in a dental benefits plan will depend on various factors, including the cost of the plan, how often participants visit the dentist and the cost of services rendered.⁴

 

Service where and when you want it.

MyBenefits, your secure self-service website through MetLife, is available 24/7.⁵ You can use the site to get estimates on care or check coverage and claim status. Plus, if you are on the go and need to find an in-network provider, view a claim or see your ID card, there’s an app for that.⁶ Search “MetLife” at iTunes App Store or Google Play to download the app.⁷

 

To check out the general dentists and specialists in the PDP network, visit metlife.com/dental. From there, select “Find a participating dentist,” then select the network “PDP Plus” and enter your ZIP code.

The right dental care is an essential part of good overall health. That’s why you and your dentist get resources to help make informed decisions about your oral health. You’ll find a range of topics on our online dental education website, oralfitnesslibrary.com. Read up on the link between dental and overall health, kids’ dental health and more. You can also put your oral health to the test by taking an online risk assessment.

View plan details, rates, list of covered services, exclusions and limitations.

Where two or more professionally acceptable dental treatments for a dental condition exist, reimbursement is based on the least costly treatment alternative. If you and your dentist have agreed on a treatment that is more costly than the treatment upon which the plan benefit is based, you will be responsible for any additional payment responsibility.  To avoid any misunderstandings, we suggest you discuss treatment options with your dentist before services are rendered and obtain a pretreatment estimate of benefits prior to receiving certain high cost services such as crowns, bridges or dentures. You and your dentist will each receive an Explanation of Benefits (EOB) outlining the services provided, your plan’s reimbursement for those services, and your out-of-pocket expense. Actual payments may vary from the pretreatment estimate depending upon annual maximums, plan frequency limits, deductibles and other limits applicable at time of payment.

This plan does not cover the following services, treatments and supplies:

1. Services that are not dentally necessary, those that do not meet generally accepted standards of care for treating the particular dental condition, or that we have deemed experimental in nature.
2. Services for which you would not be required to pay in the absence of dental insurance.
3. Services or supplies received by you or your dependent before the dental insurance starts for that person.
4. Services that are primarily cosmetic (for Texas residents, see notice page section in certificate).
5. Services that are neither performed nor prescribed by a dentist except for those services of a licensed dental hygienist that are supervised and billed by a dentist and that are for:
   – Scaling and polishing of teeth
   or
   – Fluoride treatments.
6. Services or appliances that restore or alter occlusion or vertical dimension.
7. Restoration of tooth structure damaged by attrition, abrasion or erosion.
8. Restoration or appliances used for the purpose of periodontal splinting.
9. Counseling or instruction about oral hygiene, plaque control, nutrition and tobacco.
10. Personal supplies or devices including, but not limited to water picks, toothbrushes or dental floss.
11. Decoration, personalization or inscription of any tooth, device, appliance, crown or other dental work.
12. Missed appointments.
13. Services
    – Covered under any workers’ compensation or occupational disease law
    – Covered under any employer liability law
    – For which the employer of the person receiving such services is not required to pay
    or
    – Received at a facility maintained by the employer, labor union, mutual benefit association or VA hospital.
14. Services covered under other coverage provided by the employer.
15. Temporary or provisional restorations.
16. Temporary or provisional appliances.
17. Prescription drugs.
18. Services for which the submitted documentation indicates a poor prognosis.
19. 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.
20. Dental services arising out of accidental injury to the teeth and supporting structures, except for injuries to the teeth due to chewing or biting food.
21. Caries susceptibility tests.
22. Initial installation of a fixed and permanent denture to replace one or more natural teeth that were missing before such person was insured for dental insurance, except for congenitally missing natural teeth.
23. Other fixed denture prosthetic services not described elsewhere in this certificate.
24. Precision attachments, except when the precision attachment is related to implant prosthetics.
25. Initial installation of a full or removable denture to replace one or more natural teeth that were missing before such person was insured for dental insurance, except for congenitally missing natural teeth.
26. Addition of teeth to a partial removable denture to replace one or more natural teeth that were missing before such person was insured for dental insurance, except for congenitally missing natural teeth.
27. Adjustment of a denture made within six months after installation by the same dentist who installed it.
28. Implants including, but not limited to any related surgery, placement, restorations, maintenance and removal.
29. Repair of implants.
30. Implant-supported prosthetics to replace one or more natural teeth that were missing before such person was insured for dental insurance, except for congenitally missing natural teeth.
31. Diagnosis and treatment of temporomandibular joint (TMJ) disorders. This exclusion does not apply to residents of Minnesota.
32. Repair or replacement of an orthodontic device.
33. Duplicate prosthetic devices or appliances.
34. Replacement of a lost or stolen appliance, cast restoration or denture.
35. Intra and extraoral photographic images.

Coverage is provided under a group insurance policy (Policy Form GPN99) issued by MetLife. Coverage terminates when:

• Your membership in IEEE ceases
• When insurance ends for your class
• When your dental contributions cease
• Upon termination of the group policy by the policyholder

 

The group policy terminates for nonpayment of premium and may terminate if participation requirements are not met or, if the Policyholder fails to perform any obligations under the policy. The following services that are in progress while coverage is in effect will be paid after the coverage ends, if the applicable installment or the treatments is finished within 31 days after individual termination of coverage: completion of a prosthetic device, crown or root canal therapy.

Insurance Application and Brochure

Dental Card and FAQs Download for Group Dental Plan Participants

Domestic Partner Declaration Form

California Healthcare Language Assistance Program

Dental Card for Group Dental Participants

MetLife Oral Health Library

PDP Plus Network

Preventive Dental Care for Children

Powerful Plans at the Right Price

MetLife Mobile Application

Controlling Dental Pain and Opioids

Dental Health Manager