MetLife Standard Dental Plan
MetLife Standard Dental Plan
The MetLife Standard dental plan features a lower per-paycheck contribution. For dental treatments greater than $250, you should request a Pre-Determination of Benefits Statement from your dentist so you know the out-of-pocket costs prior to beginning dental treatment.
| STANDARD PLAN |
||
|---|---|---|
| IN-NETWORK | OUT-OF-NETWORK | |
| CALENDAR YEAR DEDUCTIBLE | ||
| Individual | $25 | $25 |
| Family | $75 | $75 |
| CALENDAR YEAR PLAN MAXIMIUM | ||
| Per Individual | $800 | $800 |
| YOU PAY | YOU PAY | |
| PREVENTIVE CARE | ||
| Exams, Cleanings, X-rays, Fluoride Treatments | $0 | $0 |
| BASIC SERVICES | ||
| Fillings, Space Maintainers, Sealants, Extractions, Oral Surgery, Endodontics, Periodontics, Emergency Exams | 20% | 20% |
| MAJOR PROCEDURES | ||
| Crowns, Inlays/Onlays, Dentures and Bridgework, Repairs | 50% | 50% |
| ORTHODONTIA | ||
| Children Only (up to 19th birthday) | Not Covered | Not Covered |