Committed to providing superior customer service!!


BUYING POWER

Access to the insurance plans and large group pricing on this website is predicated upon joining Elevate Wellness, a national association with over 80,000 members. Learn more


Plan Description

 

KEY BENEFITS

  • Preventive care, such as cleanings, is usually 100% covered in-network.

  • Large network of dentists, and the freedom to visit any dentist in or out-of-network.

  • Additional savings when you visit a participating dentist. Negotiated fees for covered services, which are typically 30-45% less than the average fees charged by dentists in the same community.




Experience the MetLife difference

Preventive oral care not only provides benefits for your overall health, it also helps avoid unexpected expenses like oral surgery. Our large network and flexible coverage options help keep your out-of-pocket costs down.


 MetLife Dental
Platinum
MetLife Dental
Gold
MetLife Dental
Silver
Network      
Enrollment Deadline18th of month Prior to Effective date18th of month Prior to Effective date18th of month Prior to Effective date
NetworkPDP PlusPDP PlusPDP Plus
Provider SearchClick hereClick hereClick here
States Not Available
AK, ID, LA, ME, MD, MT, NH, NM, OR, SD, WA
Coverage Type*In-NetworkOut-of-
Network
In-NetworkOut-of-
Network
In-NetworkOut-of-
Network
Type A – Preventive100% of
Negotiated
Fee*
100% of
Negotiated
Fee*
100% of
Negotiated
Fee*
100% of
Negotiated
Fee*
100% of
Negotiated
Fee*
100% of
Negotiated
Fee*
Type B – Basic80% of
Negotiated
Fee*
80% of
Negotiated
Fee*
70% of
Negotiated
Fee*
70% of
Negotiated
Fee*
50% of
Negotiated
Fee*
50% of
Negotiated
Fee*
Type C – Major50% of
Negotiated
Fee*
50% of
Negotiated
Fee*
40% of
Negotiated
Fee*
40% of
Negotiated
Fee*

Not Covered

Not Covered
Type D – Orthodontia50% of
Negotiated
Fee*
50% of
Negotiated
Fee*

Not Covered

Not Covered

Not Covered

Not Covered
Deductible**      
Individual$25**$25**$50**$50**$50**$50**
Family$75**$75**$150**$150**$150**$150**
Annual Maximum Benefit
Per Person$3,000 (Annual Combined)$1,500 (Annual Combined)$1,000 (Annual Combined)
Orthodontia Lifetime Maximum
Per Person$2,000 (Annual Combined)Not CoveredNot Covered
    
List of Primary Covered Services & LimitationsHow Many/How Often – All Plans
Type A - Preventive 
Oral ExaminationsOne time in 6 months.
Prophylaxis (cleanings)One time in 6 months.
SealantsOne application of sealant material every 3 years for each non-restored, non-decayed 1st and 2nd molar of a dependent child up to 19th birthday.
Space MaintainersOne in 3 years for dependent children up to 14th birthday .
Topical Fluoride ApplicationsTwo times in 12 months for a dependent child under age 19.
X-raysFull mouth X-rays: one per 5 calendar years.

Bitewing X-rays: one set per calendar year for adults and one set per calendar year for dependent children under age 19.
Type B - Basic Restorative 
Amalgam FillingsOne replacement per surface in 24 months
Resin Composite Fillings (excludes coverage for composite fillings on molars)Unlimited.
Examinations-Problem FocusedCombined with Examinations Limit.
PeriodonticsPeriodontal scaling and root planing once per quadrant, every 24 months.

Total number of periodontal maintenance treatments and prophylaxis cannot exceed four treatments in 12 months.

Non-Surgical procedures
EndodonticsPulpotomy, Pulp Capping, Pulp Therapy
Oral SurgerySimple and Surgical Extractions.
Prefabricated CrownsOne per tooth in 10 calendar years.
Type C - Major Restorative 
PeriodonticsPeriodontal Surgery: one per quadrant in any 36 month period.
Full Mouth DebridementOne per lifetime
EndodonticsRoot Canal treatment limited to one per tooth per lifetime.
Crown Buildups/Post CoreOne per tooth in 10 calendar years.
Crowns/Inlays/OnlaysReplacement: one every 10 calendar years per tooth.
DenturesRebases/Relines: one in 36 months.

Adjustments: one in 12 months.

Repairs: one in 12 months.

Recementations: one in 12 months.
Bridges and DenturesDentures and bridgework replacement: one every 10 calendar years.

Replacement of an existing temporary full denture if the temporary denture cannot be repaired and the permanent denture is installed within 12 months after the temporary denture was installed.
Tissue ConditioningOne in 36 months.
ImplantsReplacement: one per tooth position every 10 calendar years.

Repairs: one per tooth in 12 months.

Supported Prosthetic: one per tooth every 10 calendar years.
Occlusal AdjustmentsOne in 12 months.
ConsultationsTwo in 12 months.
General AnesthesiaWhen dentally necessary in connection with oral surgery, extractions or other covered dental services.
Type D - Orthodontia (Platinum Plan only)Your Children, up to age 19, are covered while Dental Insurance is in effect.

All dental procedures performed in connection with orthodontic treatment are payable as Orthodontia.

Payments are on a repetitive basis.

20% of the Orthodontia Lifetime Maximum will be considered at initial placement of the appliance and paid based on the plan benefit’s coinsurance level for Orthodontia as defined in the Plan Summary.

Orthodontic benefits end at cancellation of coverage.
*Negotiated Fee refers to the fees that participating dentists have agreed to accept as payment in full, subject to any co-payments,
deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.

** Applies only to Type B & C Services.






Questions? Call 914-428-6400 We're standing by to help you make the best decision. If you are having technical difficulties or issues, please submit your issues here.