The MetLife Value Plan offers you an affordable option to secure the dental coverage that you and your family need.
While there are deductibles and coinsurance amounts to pay under this plan, it does offer valuable benefits toward the cost of dental care services and it does pay 100% of the cost of preventive care services provided by a member of the MetLife Preferred Dentist Program (MetLife PDP).
With this coverage, there are claim forms to file. Youâ€™ll be reimbursed for covered services up to the limits of the plan when the Dental Plan Administrator receives a completed dental claim form from the dentist. Claims will be considered only for services incurred while you are covered under the plan.
The benefits you receive toward the cost of covered dental services will depend on whether services are provided by a MetLife PDP participating dentist or a nonparticipating dentist:
||When the services are provided by a MetLife PDP participating dentist:
You receive maximum benefits and reduce your out-of-pocket costs for covered dental services. MetLife PDP participating dentists have agreed to discount their fees for covered services and this savings is passed along to you, reducing your out-of-pocket costs. As noted above, the plan pays 100% of the cost of preventive care services with no deductible and no coinsurance; for all other covered services, once you meet the annual deductible, you and the plan share the cost of these services through coinsurance, which is applied to the discounted fee.
||When the services are provided by a nonparticipating dentist:
Your benefits will be lower and your out-of-pocket costs will be higher for dental services provided by a dentist who is not a MetLife PDP participating dentist. Not only will the plan pay a lower percentage of the cost for these services through coinsurance (including the cost of preventive care), this coinsurance will be based on the reasonable and customary (R&C) charge for services, not the discounted fee.
To see a fact sheet that highlights key features of MetLife Value Plan coverage, click here.
To see a summary guide describing features of MetLife PDP coverage in more detail, click here.
For more information or to request a dental provider listing, contact the plan administrator, MetLife PDP by phone at (800) 942-0854 (7 a.m. to 10 p.m. CT, Monday through Friday) or online at www.metlife.com/mybenefits. For an address and fax number for written correspondence, see the Benefits Directory.