MetLife Dental

When you consider how important good oral health is to your general health, your need for good dental benefits should not be ignored.  MetLife has offered dental insurance coverage for over 40 years and is the single largest dental plan administrator among single commercial carriers in the U.S., currently serving nearly 21 million people. MetLife’s Preferred Dentist Program (PDP) network is one of the largest in the industry, exceeding 100,000 participating dentist locations and over 22,000 Specialist locations nationwide. Click here for MetLife Dental Program Benefit Summary.

Being enrolled in the MetLife PDP plan means lower out-of-pocket expenses when you visit a PDP dentist.  Whether or not the service is covered by your plan, you will always receive the MetLife PDP negotiated fee.  The negotiated fee is typically 10-35% less than the average fees charged by a dentist in your same community.

In North Carolina there are nearly 1,000 General Dentists and almost 200 Specialists in the MetLife PDP Network.  Those members living or traveling outside the state of North Carolina will be able to visit any participating dentist in the MetLife PDP nationwide network.  Of course, as always, you have the freedom of choice to visit any dentist, in- or out-of-network.

Preventive - all procedures covered at 100%*

• Oral Exams - 2 per calendar year
• Cleanings - 2 per calendar year
• Topical fluoride application - 1 per calendar year (child & adult)
• Bitewing x-rays - 1 set per calendar year
• Full mouth x-rays - 1 per 60 months
• Palliative (emergency) treatment
• Space maintainers - 1 per lifetime per area up to age 19
• Sealants - once per 60 months up to age 19
• Oral cancer screening

Minor restorative - All procedures covered at 60%*

• Amalgam restorations (fillings)
• Resin restorations (fillings)
• Crown and bridge repairs
• Periodontal scaling/root planing - 1 per 24 months per quadrant
• Periodontal maintenance therapy - 4 per calendar year, including 1110 (Adult Cleaning)
• Periodontal surgery - once per quadrant every 36 months
• Simple and surgical extractions
• Oral surgery - some limits apply (see Certificate)
• Endodontics/root canals - Once per tooth per 24 months
• General anesthesia - when dentally necessary or in connection with complex surgery; max up to 2 hours
• Consultations - 1 per 12 months

Major restorative/dentures - all procedures covered at 50%*

• Bridges - replace once every 5 years
• Dentures - replace once every 5 years**
• Denture repairs
• Adjustments to dentures**’
• Denture relining and rebasing**
• Tissue conditioning
• Crowns - 1 per tooth every 5 years
• Implants - once every 5 years per tooth

* Percentages of usual & customary fees
** Relining or Rebasing of existing Removable Dentures will be a covered dental expense not more frequently than once every 36 months (covered only after a minimum of six months after the initial installation of the device.)

NCRGEA members can view claims information and find a participating dentist via the metlife MyBenefits website at www.metlife.com/mybenefits.

As the sponsor of the MetLife plan, NCRGEA receives no money from MetLife. We sponsor this plan strictly as a benefit to our members so we will be happy to discuss the differences between the two plans with you. However, you will need to decide which is the better plan for your needs.

If you would like additional information regarding the MetLife Dental Plan, please contact Susan Warren at susanw@ncrgea.com or 1-800-356-1190.