Oral health is an essential part of your overall health. Dental insurance can make that care more affordable. MetLife Dental Insurance offers a range of coverage to meet your needs and your budget. Learn more in this MetLife Dental Insurance review.
In general, MetLife offers comprehensive dental insurance coverage. The benefits MetLife offers ultimately depends on your employer – read your summary of benefits carefully so you know what is and isn’t covered.
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 like fillings and extractions.
- Major services: This includes more significant restorative services like bridges, crowns, root canals, as well as dentures and denture repairs.
- Orthodontic: 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 will work depends on which plans your employer chooses from MetLife. In general, this is how coverage works.
You’ll pay a set amount out of 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’re required to pay before MetLife begins covering your dental care. You’ll also have to pay coinsurance. Coinsurance is the percentage of a covered service you’re responsible for.
Your coinsurance amount 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 an in-network provider. You might also pay:
- 45% of intermediate services
- 65% of major services
- 50% of orthodontic services
If you have a PPO and see an out-of-network provider, you may pay more. Your coinsurance may be:
- 40% of basic services
- 60% of intermediate services
- 80% of major services
- 50% of orthodontic services
Most dental plans also have annual maximums. This is the most your plan will pay for covered services. For example, you may have a $ 1,500 annual maximum 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 child.
Some plans have a waiting period. This is the amount of time you have to wait after starting coverage to receive certain services. You might be able to receive basic services right away, but you may have to wait 6 months for intermediate, major and orthodontic services.
What Isn’t Covered
MetLife, like all insurance companies, has exclusions to its benefits. That means that it will not pay for care in certain circumstances. Some exclusions include:
- Services and treatment performed before your coverage starts
- Services and treatments that aren’t considered necessary
- Services and treatments that are experimental
- Injuries related to employment (those may be covered under workers compensation)
- Services related to diagnosing and treating TMD / TMJ
- Self-inflicted injuries
- Injuries resulting from committing a felony
- Charges for copies of your records
- Charges due to canceled appointments
- Replacements of dentures that have been stolen or lost
- Nitrous oxide
- Oral sedation
- Local anesthesia
- Cosmetic treatments (like teeth whitening)
- Duplicate devices
- Injuries related to a vehicle accident if those injuries are covered by auto insurance
Implants are only covered if they’re medically necessary. MetLife reviews implant claims to determine whether they’re required or if another procedure can be used instead.
Dentists often submit the claims paperwork on your behalf. If they don’t 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 is the simplest option, obviously, and mailing or faxing in claim forms is tedious, but at least you can easily see what’s going on with your claims regardless of how they’re submitted.
With the MetLife mobile app, you can find a dentist, view your ID card, switch dentists, view your plan information and review claim summaries. If you have other MetLife policies, you can manage them through the app as well. The app is available in the Apple App Store and in the Google Play store.
MetLife Dental Insurance is offered exclusively through employers. Most employers cover some or all of the cost of benefits like dental insurance, which keeps your costs down. As with any insurance decision, review the dental insurance options your employer offers and compare them based on the premium (the amount you pay per paycheck), deductibles, coinsurance, copays 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 doesn’t list its customer service hours on its website, and it doesn’t have options other insurance companies have such as live chat on its website or through its mobile app.
Overall, MetLife offers extensive 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 benefit plans from MetLife, so some services may not be available or may be covered with a different amount of coinsurance than the examples we used. MetLife’s 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 or it may allow you to choose from multiple insurance companies. If that’s the case, compare your options carefully, looking at the premium, deductible, coinsurance and maximum annual benefits. You should also compare the coverage. For example, if you have a child who needs orthodontic work, it’s best to choose a plan that covers that type of care.
MetLife has an extensive network of dentists, and you can find a dentist near you using its website or mobile app. If you already have a dentist, check to see if that dentist is in MetLife’s network. If they’re not, you may pay more if you have a PPO or that dentist may not be covered at all.
Alternatives to MetLife
What if you don’t have access to dental coverage through an employer? In that case, you can purchase a separate dental insurance policy. Although you can’t purchase MetLife, many other insurance providers offer plans you can purchase directly. Get quotes from at least 2 or 3 companies and compare them to find affordable dental insurance that works for you.
You may be able to find dental insurance plans through your state’s Health Insurance Marketplace. You can also visit websites that allow you to get quotes from multiple insurance companies.
Another option is getting a dental discount plan rather than an insurance plan. With dental discount plans, you pay a low monthly or annual fee. You can go to any dentist who accepts the plan and the discount is taken upfront. You don’t have to file a claim. You can get a quote on dental discount plans and other options from our trusted partner.
Most adults prefer Invisalign over braces because they adjust your teeth quicker and are less noticeable. What’s not as noticeable is the price tag. And why does the average price change from state to state? Short answer the price is influenced by a number of factors but office location can mean higher or lower costs based cost of living.
On the low end, you can expect to pay $ 3,000 for a round of Invisalign and $ 9,000 on the high end. The highest price we’ve seen for Invisalign is in California while the cheapest is in Texas. For a middle of the road price, you can look to Arkansas, Kentucky, Mississippi, Missouri and North Carolina.
It’s possible your insurance might cover a portion of Invisalign treatments. See a list of dental insurance providers to compare coverage and a list of dental insurance that covers the Invisalign alternative, braces.
DentalInsurance.com is a wholly-owned subsidiary of Kelsey National Corporation (KNC). A leading provider of dental insurance, DentalInsurance.com was the first to let individuals comparison-shop and apply for dental insurance and discount dental plans online.
DentalInsurance.com provides families, individuals and business owners with the easiest way to compare and purchase affordable, quality dental insurance and discount dental plans.
