Do I need to select a dentist who participates in the network when I enroll? Collapsed Expanded

Yes. At the time of enrollment, you will select two participating dentists. This will help ensure you are able to receive the care you need if your first choice is unable to accept new members. The participating dentist you select at enrollment will provide your routine dental care. You may schedule an appointment with your dentist any time after your plan’s effective date. Please note: Except for Emergency Dental Services, out-of-network benefits are not available through this DHMO plan.

Who are the dentists who participate in your network? Collapsed Expanded

This plan’s network includes both private practice dentists and those who are in a clinic environment. Every dentist in the network has been thoroughly screened prior to acceptance. Participating dentists are also subject to regular audits, including onsite visits to the dental offices. You can find the names, addresses, languages spoken and telephone numbers of participating dentists by searching our online Find a Dentist directory for the most up-to-date information.

Can I change dentists? Collapsed Expanded

Yes. You and your enrolled dependents may each select different participating dentists and may change dentists as often as once per month. You can change dentists for you and your enrolled dependents online or by calling Customer Service. Your transfer will be effective the first of the following month. Please note: you should ensure any dental work-in-progress is completed prior to transferring to a new dentist. Refer to your Evidence of Coverage included in the “Your Benefits” section of this site and with your enrollment materials for more information.

What if I need emergency care? Collapsed Expanded

All participating dental offices in our network provide emergency access 24 hours a day, 7 days a week. If you cannot reach your selected participating dentist, you may receive emergency care from any licensed dental care professional. The definition of what is considered “emergency care” and other specifics can be found in the Evidence of Coverage included in the “Your Benefits” section of this site and with your enrollment materials.

I noticed some dental offices in your directory appear to be closed to new members. What if one of them is my current dentist? Collapsed Expanded

While these facilities cannot accept new patients, you may not have to change dentists if you are currently a patient in one of those offices. It is important that you contact Customer Service in order to ensure that you can continue using your current facility under the plan.

What if I need to see a specialist? Collapsed Expanded

This is a "direct referral" plan which means your selected participating dentist will refer you to a participating specialist in your area – there is no need to wait for approval.* Any copayment amounts for services listed on your Schedule of Benefits. This copayment applies whether the services are provided by your selected participating general dentist or by a participating specialist.

Do these plans cover second opinions? Collapsed Expanded

Yes. Just contact Customer Service to let us know that you would like another clinical opinion and we will provide the name of a dentist for you to see.

Do I need an ID card to receive services? Collapsed Expanded

No. We will provide you with an ID card when you enroll, but it is not necessary to receive services.  The card is not a guarantee of coverage or eligibility, but does highlight toll free numbers and the web address that can be used to access benefit information about your dental plan.

Your selected general dentist receives a list every month of all DHMO members enrolled in his or her practice and may also verify eligibility with us prior to your appointment.

If you would like a card, there is also a temporary ID card in the front of your enrollment kit, or you can print one from our interactive website.

Does everyone in my family have to go to the same dentist? Collapsed Expanded

No. You and your dependents may select different dentists. Just make sure you include the facility numbers on the Provider Selection Form for the facilities each family member has chosen. If your form is submitted without facility numbers, there could be a delay in being able to access care.

Does my plan cover any cosmetic procedures? Collapsed Expanded

Your Nexus 150 plan includes many of the most popular cosmetic procedures available today. Bleaching, veneers, white fillings, and adult & child orthodontics (braces) are all included at copayments that may be considerably lower than you would pay without this dental benefit plan.1

Please refer to your Schedule of Benefits for complete information.

* In California, orthodontic and pedodontic specialty services require pre-approval. Your selected participating dentist will contact SafeGuard for pre-approval. Once approved, your dentist will contact you with the name of a participating specialist

Savings from enrolling in a group benefit program will depend on various factors, including how often participants visit the dentist and the costs for services received.

Dental Managed Care Plan benefits are provided by Metropolitan Life Insurance Company, a New York corporation in NY. Dental HMO plan benefits are provided by: SafeGuard Health Plans, Inc., a California corporation in CA; SafeGuard Health Plans, Inc., a Florida corporation in FL; SafeGuard Health Plans, Inc., a Texas corporation in TX; and MetLife Health Plans, Inc., a Delaware corporation and Metropolitan Life Insurance Company, a New York corporation in NJ. The Dental HMO/Managed Care companies are part of the MetLife family of companies. "DHMO" is used to refer to product designs that may differ by state of residence of the enrollee, including but not limited to: "Specialized Health Care Service Plans" in California; "Prepaid Limited Health Service Organizations" as described in Chapter 636 of the Florida statutes in Florida; "Single Service Health Maintenance Organizations" in Texas; and "Dental Plan Organizations" as described in the Dental Plan Organization Act in New Jersey.

Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact MetLife or your plan administrator for complete details.