2025 Dental

To provide employees with the most valuable and cost-effective dental coverage, MetLife will be the new dental insurer for 2025.  The MetLife Standard and MetLife Premium Plans will be offered with similar benefits as the current plans.  In addition, a new lower-cost base dental plan will be available.  The New Base dental Plan Option has the lowest premiums and lowest annual maximum benefit, with coverage for preventive and basic services only.The Standard plan is the “mid-level” plan, with coverage for major services but no coverage for orthodontic care.  The premium plan is the richest option, with coverage for orthodontia, the highest maximum benefit, and a lower deductible.

 

 

 

Premium Information

Important Documents

Preventive care, or Type A services such as cleanings, exams, and x-rays are covered on all three plan options at 100% with no deductible. Type B services include but are not limited to fillings, simple extractions, and periodontal scaling and root planning  You pay a deductible first, and then the plan pays 80% coinsurance. Major or Type C services like bridges, crowns, and root canals are covered at 50% after the deductible on the Standard and Premium plans.  Orthodontia is covered at 50% up to a $1,500 lifetime maximum on the Premium plan only. 

As long as you access a MetLife PDP Plus dental network provider, your claim will be processed at the in-network level with no balance billing. Services not covered or that exceed the calendar year maximum are the patient’s responsibility. 

We encourage you to use a MetLife PDP Plus provider in order to maximize your dental plan benefits. Access www.metlife.com/dental to locate participating dental provider information. Refer to the dental benefits summary for complete details regarding frequencies and coverage information.  Participating dentist information can be found on the Resources page.

Below is a benefit summary of your annual deductible and co-insurance costs.

MetLife Dental Coverage Base Plan Standard Plan Premium Plan
Deductible
$75 individual
$225 Family
$75 individual
$225 Family
$50 individual
$150 Family
Type A - Preventive Services (Deductible Waived):
Cleanings, exams, fluoride, x-rays (including full mouth), sealants and more
Plan pays 100% Plan pays 100% Plan pays 100%
Type B - Basic Services (After Deductible):
Fillings, simple extractions, general anesthesia, periodontal scaling, and root planing.
Plan pays 80% Plan pays 80% Plan pays 80%
Type C - Major Services (After Deductible):
Periodontal surgery, major periodontics, bridges, dentures, crowns, and root canals.
Not Covered Plan pays 50% Plan pays 50%
Type D - Orthodontia (After Deductible):
Adults and children
Not Covered None Plan pays 50%
Orthodontia Lifetime Maximum
None None $1,500 per person
Annual Maximum (per person)
$750 per person $1,000 per person $2,000 per person

Important Notes


  • Deductible (waived for preventive); differing annual maximums depending on plan
  • Members utilizing MetLife participating dentists will enjoy discounted dental fees in addition to protection from balance billing for charges above the dentist’s maximum allowable charges. Members utilizing non-participating dentists will have the same benefits, but may be subject to balance billing.

Claims Process


In-Network

  • Participating MetLife dentists file the claim and accept payment from MetLife
  • Employees should not need to pay at the time of service for participating providers

 

Out-of-Network

  • For out-of-network dentists, if the dentist does not agree to file the claim as out-of-network with MetLife, employee pays at the time of service and files a claim for reimbursement
  • Charges by out-of-network providers that exceed Usual & Customary are the member’s financial responsibility. (Member pays the difference between the actual charge and the plan’s U&C reimbursement level.)

Virtual Dental Care


The MetLife Dental Plan offers virtual dental care for times when you're in pain or unable to visit a dentist in person. You can consult with a licensed dentist through a video call. Simply log in to your MyBenefits Account at online.metlife.com, and choose "Start Virtual Visit" to begin.