2022 – 2023 Dental Plan Options for CA/National Employees:
DHMO plan: you choose a primary care dentist and receive all of your care within the plan’s network — there is no out-of-network coverage. There is also no deductible or annual maximum benefit under the DHMO plan.
High and Low plans: you can see any dentist you want, but you must first meet a deductible before coverage begins. These plans also include an annual maximum benefit. The differences between the High and Low plans is in the deductibles, annual maximums, out-of-network coverage, and orthodontic lifetime maximums.
All the dental plans include:
- Affordable coverage that helps you manage the cost of dental treatment
- Wide network of providers that have agreed to negotiated rates, which helps you save money (reminder: the DHMO plan only pays benefits for care received in network)
- Choice of four coverage levels:
- Employee Only
- Employee Only + Spouse/Domestic Partner
- Employee + Children up to age 26
- Employee + Family
Use Your Dental Benefits Wisely
Here’s how to make the most of your dental benefits:
- Choose your provider – Each time you need dental care, you have a choice of providers. Selecting a participating dentist in the MetLife network will ensure you receive the highest benefits from your plan.
- If your service is expected to exceed $300, submit a request for a pretreatment estimate – (such as crowns, inlays, bridges, and periodontics). For more information about pretreatment estimates, call your dental carrier.
- Check your claim status and other information – on MetLife’s website. You can review Explanation of Benefits (EOB) statements, check if claims have been paid, and more.
|Plan Details||MetLife DHMO Plan||MetLife Low Plan||MetLife High Plan|
|Primary Care Dentist||Yes||No||No||No||No|
|Annual Maximum Benefit||None||$1,500||$1,000||$1,500||$1,500|
|Diagnostic and Preventive Care Services||Fee schedule||Covered in full||You pay 20%, no deductible||Covered in full||Covered in full|
|Basic Services||Fee schedule||20% after deductible||50% after deductible||20% after deductible||20% after deductible|
|Major Services||Fee schedule||50% after deductible||50% after deductible||50% after deductible||50% after deductible|
|Orthodontics (adults and children)||Fee schedule||40% after deductible||40% after deductible||40% after deductible||40% after deductible|
|Orthodontic Lifetime Benefits (adults and children)||Fee schedule||$1,000||$1,000||$2,500||$2,500|