Oral health is an essential part of your overall health. Dental insurance can make this care more affordable. MetLife Dental Insurance offers a range of coverage to meet your needs and budget. Learn more in this MetLife dental insurance review.
In general, MetLife offers comprehensive dental insurance coverage. The benefits offered by MetLife ultimately depend on your employer – read your summary of benefits carefully so you know what is covered and what is not.
Types of coverage
MetLife covers several types of dental services:
- Basic services: This includes preventive and diagnostic services like cleaning, lab tests, diagnostic models, sealants, fluoride treatments, space maintainers, and routine x-rays.
- Intermediate services: This includes restorative services such as fillings and extractions.
- Major services: This includes larger restorative services like bridges, crowns, root canals, as well as dentures and denture repairs.
- Orthodontics: This coverage includes braces, space maintainers and other options to align your teeth.
You’ll typically pay a percentage of the cost of the service, with the plan paying the rest.
How dental insurance works
Exactly how your plan works depends on which plans your employer chooses from MetLife. In general, this is how hedging works.
You will pay a fixed amount on each paycheck, called a premium. Premiums are deducted automatically.
When you use your plan, you may have to pay a deductible. This is the amount you must pay before MetLife begins to cover your dental care. You will also have to pay coinsurance. Coinsurance is the percentage of a covered service for which you are responsible.
The amount of your coinsurance will vary depending on the type of service you receive. For example, you may not have to pay coinsurance for basic services you receive from a network provider. You could also pay:
- 45% of intermediary services
- 65% of major services
- 50% of orthodontic services
If you have a PPO and see an out-of-network provider, you can pay more. Your coinsurance can be:
- 40% of basic services
- 60% of intermediary services
- 80% of major services
- 50% of orthodontic services
Most dental plans also have annual maximums. This is the maximum your plan will pay for covered services. For example, you may have an annual maximum of $1,500 for in-network benefits and a $1,000 benefit for out-of-network benefits. There may be a lifetime maximum benefit for orthodontic services. The maximum for orthodontic services may also vary depending on whether the person receiving the benefits is an adult or a child.
Some plans have a waiting period. This is the time you must wait after coverage begins to receive certain services. You may be able to receive basic services immediately, but you may have to wait 6 months for intermediate, major and orthodontic services.
What is not covered
MetLife, like all insurance companies, has exclusions to its benefits. This means that he will not pay for care under certain circumstances. Some exclusions include:
- Services and treatments performed before your coverage begins
- Services and treatments that are not deemed necessary
- Experimental Services and Treatments
- Job-related injuries (these may be covered by workers’ compensation)
- Services related to the diagnosis and treatment of TMD/TMJ
- Self-inflicted wounds
- Injuries resulting from the commission of a crime
- Fees for copying your files
- Expenses due to canceled appointments
- Replacements for stolen or lost prostheses
- Nitrous oxide
- Oral sedation
- Local anesthesia
- Cosmetic treatments (such as teeth whitening)
- Duplicate devices
- Injuries related to a vehicle accident if these injuries are covered by automobile insurance
Implants are only covered if medically necessary. MetLife reviews implant claims to determine if they are necessary or if another procedure can be used instead.
Dentists often submit claim documents on your behalf. If not, you can download a claim form from the MetLife website and mail or fax it to MetLife. You can track the status of your claims online or by using the mobile app.
Dentists handling claims are obviously the easiest option, and mailing or faxing claim forms is cumbersome, but at least you can easily see what’s going on with your claims, regardless of how they are submitted.
With the MetLife mobile app, you can find a dentist, view your ID card, change dentists, view your plan information, and view claim summaries. If you have other MetLife policies, you can also manage them through the app. The application is available in the Apple App Store and in the Google Play store.
MetLife dental insurance is offered exclusively by employers. Most employers cover some or all of the cost of benefits like dental insurance, reducing your costs. As with any insurance decision, review the dental insurance options offered by your employer and compare them based on premium (the amount you pay per paycheck), deductibles, coinsurance, copayments and plan limits.
MetLife offers two options for customer service. You call them at 800-942-0854. You can also contact customer service by filling out a form on the MetLife website. MetLife does not list its customer service hours on its website or offer options for other insurance companies, such as live chat on its website or through its mobile app.
Overall, MetLife offers many benefits to its members, making it one of the best dental insurance providers. It offers comprehensive dental services and PPO and HMO options.
Keep in mind that each employer selects MetLife’s benefit plans, so some services may not be available or may be covered by a different coinsurance amount than the examples we’ve used. MetLife dental HMOs are only available in California, Florida, Texas, New York and New Jersey. Its dental PPOs are more widely available.
Your employer may exclusively offer MetLife for dental care, or they may allow you to choose from several insurance companies. If so, carefully compare your options by looking at premium, deductible, coinsurance and maximum annual benefits. You should also compare coverage. For example, if you have a child who needs orthodontic work, it is best to choose a plan that covers this type of care.
MetLife has an extensive network of dentists, and you can find a dentist near you using their website or mobile app. If you already have a dentist, check to see if that dentist is part of the MetLife network. If they aren’t, you might pay more if you have a PPO or that dentist might not be covered at all.
Alternatives to Met Life
What if you don’t have access to dental coverage through an employer? In this case, you can take out a separate dental insurance policy. Although you cannot purchase MetLife, many other insurers offer plans you can purchase directly. Get quotes from at least 2 or 3 companies and compare them to find affordable dental insurance that’s right for you.
You may be able to find dental insurance plans in your state’s health insurance market. You can also visit websites that allow you to get quotes from several insurance companies.
Another option is to get a dental discount plan rather than an insurance plan. With dental discount plans, you pay low monthly or annual fees. You can go to any dentist who accepts the plan and the discount is taken up front. You don’t have to file a claim. You can get a quote on dental discount plans and other options from our trusted partner.
Get 10% off any dental savings plan at DentalPlans.com. You can reduce your dental costs by saving 10-60% at the dentist!