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En Espanol blue2023 Dental Plans

There are no changes or rate increases for any of the dental plans in 2023.

The Standard and Premium maximum allowable charge (MAC) plans offer pre-determined fees for dental services with specific in-network providers to help you get quality care at better prices. Out-of-network providers may be used but may charge much higher rates for the services than the fees that MetLife has negotiated with in-network providers1. If you choose to see an out-of-network provider, you will be required to pay the difference between the actual charge and the approved in-network fee for that service in addition to any applicable co-insurance. It’s important to make sure your dental provider is in-network to avoid unnecessary out-of-pocket costs.

The Premium Access Plus Plan still offers access to all dental providers in the MetLife network and has the same coinsurance levels, deductibles and plan maximums as the Premium MAC plan. However, the Premium Access Plus Plan pays out-of-network claims based on reasonable and customary charges. Under this plan, your out-of-pocket expenses are lower for out-of-network providers.

With the Standard and Premium MAC plans, it’s important to make sure your dental provider is in-network to keep your out-of-pocket costs low. Find an In-network Dentist or call MetLife Dental at 855-488-0520.

1 Negotiated Fees refers to the fees that in-network dentists have agreed to accept as payment in full for covered services, subject to any co-payments, deductibles, cost sharing and benefits maximums.  Negotiated fees are subject to change.

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Plan Coverage

All of the MetLife Dental plans cover 100% of your family’s preventive dental care up to the annual maximum, which includes dental exams and cleanings, when you use an in-network dentist.

Below is an overview of each plan’s benefits:
  • The deductibles apply to basic and major restorative dental care.
  • The PDP Fee refers to the fees that In-network dentists (Participating Dental Providers) have agreed to accept as payment in full, minus deductibles and co-insurance.
  • For the Premium and Standard MAC plans, out-of-Network applies the same co-insurance to the PDP fee (Maximum Allowable Charge). You are responsible for the difference between actual charge and PDP fee.
  • For the Premium Access Plus Plan, out-of-Network applies the same co-insurance to the Reasonable and Customary Charges (R&C).

It is recommended that you request a pre-treatment estimate for services in excess of $300. Have your dentist submit a request at www.metdental.com or call 1-877-MET-DDS9. In most cases the estimate can be verified while you are still in the office.

Plan Comparison
2023 Dental Plan Comparison 
The PDP Fee refers to the fees that In-network dentists (Participating Dental Providers) have agreed to accept as payment in full, minus deductibles and co-insurance.

What is the difference between the Premium MAC and the Premium Access Plus Plans?
Our new Premium Access Plus Plan still offers access to all dental providers in the MetLife network and has the same coinsurance levels, deductibles and plan maximums as the Premium MAC Plan. However, the Premium Access Plus Plan will pay out-of-network claims based on reasonable and customary charges while the MAC Plan will pay out-of-network claims based on PDP fees.
 

For service details, see Benefit Summaries below.

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Dental Rates

23 Dental Rates

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Find a Dentist

Find an In-network Dentist here or call MetLife Dental at 855-488-0520.

1. Choose Mohawk ESV., Inc. as the group name:

DentalProvider1

 

 

2. Create a login if you have not previously done so in order to view claims history and plan details or search for a provider on the landing page:

DentalProvider2A

   

View Your Claims, Coverage and More

Login to Metlife.com to
  • View your coverage
  • Access your claims
  • Access procedure fee tool

Access Metlife's website and login with your username and password or create an account.

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Additional Information

pdf button Standard Mac Plan Summary

pdf button Premium Mac Plan Summary

pdf button Premium Access Plus Plan Summary

pdf buttonDental FAQ

pdf buttonGuide to your Explanation of Benefits (EOB)

pdf buttonDentist Nomination Form

pdf buttonDental Claim Form

Summary Plan Descriptions

pdf button MAC Standard Dental Plan

pdf button MAC Premium Dental Plan

pdf button Premium Access Plus Dental Plan

pdf button Out of Area Standard Plan Option

pdf button Out of Area Premium Plan Option

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Contact the Benefits Service Center or MetLife

For questions about your benefits including claims, eligibility, or to order an ID card contact us at

Benefits Service Center | 1-866-481-4922

MetLife1-855-488-0520 | Metlife

 

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