1 Savings from enrolling in a dental benefits plan will depend on various factors including the cost of the plan, how often participants visit a dentist and the cost of services rendered.
2 The Annual Maximum will increase by $200 in the Standard Option, and by $500 in the High option on January 1st following completion of 12 months of enrollment in the selected option.
3 Adult orthodontia unavailable.
4 IN-NETWORK: Negotiated fees with participating dentists are typically 30% to 45% less than average dental charges in the same community based on MetLife data. Negotiated fees refer to the fees that participating (in-network) dentists have agreed to accept as payment in full for covered services rendered by them , subject to any deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. For in-network covered services, the percentages shown are the percentage of the negotiated fee that is covered by the plan. Negotiated fees may also apply to services your dental plan does not cover or services received after you’ve reached your annual plan maximum, depending on applicable law.
5 OUT-OF-NETWORK: Reimbursement for out-of-network services is based on the lesser of the dentist’s actual fee or the Maximum Allowable Charge (MAC). The out-of-network Maximum Allowable Charge is a scheduled amount determined by MetLife.
Like most group benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, reductions, limitations, waiting periods, and terms for keeping them in force. Please contact MetLife or view the VADIP Plan Summary for cost and complete details.
The service categories and plan limitations shown above represent an overview of your plan benefits. This document presents the majority of services within each category, but is not a complete description of the plan.