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I N T R O D U C I N G Metropolitan Life Insurance Company One Madison Avenue, New York, NY 10010 [L0310H0OH(exp0205)MLIC-LD] Voluntary Dental Plan MetLife’s
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There’s No Need to Pre-Select a Primary Dentist There’s No Referral Process to Visit a Specialist Access to a Nationwide Network of Participating Dentists Rigorous Provider Credentialing Program No Waiting Periods for Major Services Consider These Features... What Does the MetLife PDP Offer Me?
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How Can I Save Money by Visiting a PDP Dentist? You Save More When You Visit a Participating PDP Dentist Scheduled Fees Typically 10% - 30% Below Community Average Typically Lower Out-of-Pocket Expenses for Non- Covered Services and discounts continue even after the calendar year maximum is met. (Some state restrictions may apply). Advantages of Visiting a Participating PDP Dentist
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To Find a Participating Dentist Near Your Home or Work… Visit: www.metlife.com/dental Or Call: 1-800-474-PDP1 (7371)
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Benefits Plan Design Type A: Preventive Services Exams Bitewing-X rays Fluoride Treatment Cleanings Services Provided IN-NETWORK: Percentage of Scheduled PDP Fee OUT-OF-NETWORK: Percentage of R&C Allowance 100% Deductible is Waived No out-of-pocket costs 80% Deductible Applies [*The Reasonable and Customary fee is based on the lowest of the Dentist’s actual charge, the Dentist’s usual charge or the charge of most dentists in the same area for the same or similar services as determined by MetLife.]
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Type B: Basic Services Fillings ( Includes White Fillings) Full Mouth X-Rays Simple Extractions Services Provided IN-NETWORK: Percentage of Scheduled PDP Fee OUT-OF-NETWORK: Percentage of R&C Allowance Type C: Major Services Inlays/Onlays/Crowns Implants/Bridges/Dentures Root Canal and Periodontics Annual Maximum Benefit (Per Person) Services Covered at 80% Deductible Applicable Services Covered at 50% Deductible Applicable Services Covered at 60% Deductible Applicable Services Covered at 40% Deductible Applicable Annual Deductible $50 Individual /$150 Family $1,000 per Person $50 Individual /$150 Family
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Advantage of Using In-Network Provider Advantage of Using In-Network Provider In-Network Dentist’s Usual Charge [$1200.00] Negotiated Fee [$800.00] Plan Pays 50% of PDP Fee -[$400.00] Your Out-of-Pocket Cost [$400.00] Out-of-Network Dentist’s Usual Charge [$1200.00] ** Plan Pays 40% [-$480.00] Your Out-of-Pocket Cost [$720.00] * The Plan pays [50%] of the PDP fee for Major Services when you visit a participating dentist. You saved $320 by visiting a PDP Dentist! ** If your dentist’s usual charge is higher than the [R&C] fee determined by MetLife, you are also responsible for the difference between the dentist’s actual charge and the R&C Allowance. Please note: This example assumes that your annual deductible has been met.
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Other Services Vision Benefit Offered through Cole Managed Vision You and your dependents can receive discounts on eyecare services and eyewear products at participating providers nationwide. www.colemanagedvision.com/metlifevisionsavings Plan Number 47234
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Additional Information Available www.metlife.com/dental 1-800-275-4638 Customer Service 1-800-474-PDP1 for Provider Information www.metlife.com/MyBenefits www.metlife.com/dental 1-800-275-4638 Customer Service 1-800-474-PDP1 for Provider Information www.metlife.com/MyBenefits 18000225769(1198) Printed in U.S.A.
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