Benefits Dental Insurance
Group Number 139210
1-800-942-0854
Both retiree dental plan options offer MetLife’s negotiated fees for all in-network services, which can save you money on out-of-pocket costs. The negotiated fees even extend to non-covered services, which include services provided after the annual benefit maximum is exceeded.
Retiree Dental Summary of Benefits
MetLife | ||||
Plan Features | Option 1 | Option 2 | ||
Coverage Type | In-Network | Out-of-Network | In-Network | Out-of-Network |
Preventive | 100% of PDP Fee1 | 100%2 | 100% of PDP Fee1 | 100%2 |
Basic Restorative | 70% of PDP Fee1 | 70%2 | 70% of PDP Fee1 | 70%2 |
Major Restorative | 0% of PDP Fee1 | 0%2 | 70% of PDP Fee1 | 50%2 |
Deductible3: | In-Network | Out-of-Network | In-Network | Out-of-Network |
Retiree Only | $75 | $75 | $75 | $75 |
Retiree + 1 | $150 | $150 | $150 | $150 |
Retiree + 2 or more | $225 | $225 | $225 | $225 |
Annual Maximum: | In-Network | Out-of-Network | In-Network | Out-of-Network |
Per Person | $750 | $750 | $1,500 | $1,500 |
Please Note:
Premiums: Individual Costs vary. To determine your individual cost, refer to the retiree packet from WoodmenLife, the enrollment packet from MetLife or call MetLife directly.
If you’re currently under a treatment plan, COBRA coverage may be the best option for your enrollment to complete treatment. Upon completion of treatment (or at end of 18 months), contact MetLife for your enrollment packet for Retiree Dental.
Benefit start date will be dependent upon when your completed enrollment is received by MetLife. If received before 15th of month, your coverage will start on the 1st of following month. If enrollment is received after the 15th of month, coverage starts the 1st of second following month.
Disclosures
PDP Fee refers to the fees that participating dentists have agreed to accept as payment in full.
Reasonable and customary charges are based on the research of a dentist’s usual, actual and community average charge as determined by MetLife.
Applies only to Basic and Major Services