Metlife Dental Copay

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Best for Additional Benefits: MetLife Dental Insurance. You'll typically also have to pay a copay or coinsurance for covered services. A copay is a set dollar amount. For example, you might. The University of Chicago offers a choice of two dental plans, the MetLife Dental PPO Plan and the MetLife Dental Copay Plan. Under either of the two plans, you are free to visit any licensed dentist you choose. However, you save money if you visit a preferred provider, also called a participating PDP (Preferred Dentist Program) dentist. If the MetLife dental benefit plan is primary, MetLife will pay the full amount of benefits that would normally be available under the plan. If the MetLife dental benefit plan is secondary, most coordination of benefits provisions require MetLife to determine benefits.

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Dental Plans

The University of Chicago offers a choice of two dental plans, the MetLife Dental PPO Plan and the MetLife Dental Copay Plan.

Regular visits to the dentist may do more than just brighten your smile - they can be important to your overall health. Many diseases produce oral signs and symptoms. Both of the dental plans provide coverage for preventive care, basic care, major care and orthodontia.

Choosing and personalizing your benefits depends on your specific dental care needs, budget, and the type of plan you prefer. Under both plans, you are free to visit any licensed dentist you choose. You can comparethe two plans to determine which one best suits your dental needs.

Plan

The dental plans offer a large network of contracting providers to choose from when dental care is needed. To find a preferred provider, visit metlife.com or call (800)942-0854. Reference the 'PDP Plus' network.

MetLife Dental PPO Plan

Metlife Dental Copay

The MetLife Dental PPO Plan is a dental preferred provider organization (PPO). Each time you need care, you can visit any licensed dentist you choose. However, if you visit apreferred network provider, you save money since providers in the network charge negotiated rates. After you meet your annual deductible, the plan covers a percentage of the cost of your necessary care, up to the maximum annual benefit.

Yourcostfor the plan depends on the coverage you select (see Cost of Coverage below).

Select benefit design features are provided below.

Inside MetLife NetworkOut of MetLife Network
Choice of DentistLimited to MetLife NetworkAny dentist
Deductible Per individual: $60*

Annual Maximum

The most coverage that the Plan will provide you in one year.

Per individual: $1,500

Per family: Up to $3,000

Preventive Care

Two visits per calendar year

You pay 0%;

Plan pays 100%**

You pay 0%;

Plan pays 100%***

Basic Care
You pay 20%;

Plan pays 80%**

You pay 20%;

Plan pays 80%***

Major Care
You pay 50%;

Plan pays 50%**

You pay 50%;

Plan pays 50%***

Orthodontia
(Adult and Child)
You pay 50%;

Plan pays 50%**

Lifetime maximum per individual:$1,000
You pay 50%;

Plan pays 50%***

Lifetime maximum per individual:$1,000

*Deductible waived for Preventive and Orthodontia

**Payment for percentage of negotiated fees as determined by MetLife, subject to cost sharing, deductible and benefit maximums.

***Payment for percentage of reasonable and customary charges as determined by MetLife. You are responsible for 100% of any charges in excess of the reasonable and customary charge.

MetLife Dental Copay Plan

The MetLife Dental Copay Plan is a dental plan in which you make a copay based on a fee schedule, called the Procedure Charge Schedule. The Procedure Charge Schedule is based on the ZIP code where your dentist's office is located. Each time you need care, you can visit any licensed dentist you choose. However, if you visit apreferred network provider, you save money since providers in the network charge lower negotiated rates. If you visit an out-of-network provider you must meet an annual deductible, you pay a higher copay and your annual maximum benefit is reduced.

Metlife Dental Copay

Yourcostfor the plan depends on the coverage you select (see Cost of Coverage below).

Select benefit design features are provided below, including the copay percentage you may be asked to pay at the time dental services are rendered.

In-networkOut-of-network
Choice of DentistLimited to MetLife NetworkAny licensed provider
DeductibleNone

Per individual: $75*

Per family: Up to $225*

Annual Maximum

The most coverage that the Plan will provide you in one year.

Per individual: $5,000Per individual: $1,000

Preventive Care

One visit in a six month period.

You pay 10%;

Plan pays 90%**

You pay 30%;

Plan pays 70%***

Basic Care
You pay 30%;

Plan pays 70%**

You pay 60%;

Plan pays 40%***

Major CareYou pay 50%;

Plan pays 50%**

You pay 70%;

Plan pays 30%***

Orthodontia

(Adult and Child)

You pay 50%;

Plan pays 50%**

Lifetime maximum per individual: $1,500

You pay 60%;

Plan pays 40%***

Lifetime maximum per individual: $500

* Waived for orthodontia

Metlife dental copay vs ppo

** Payment for percentage of negotiated fees as determined by MetLife, subject to cost sharing, deductible and benefit maximums.

***Payment for percentage of reasonable and customary charges as determined by MetLife. You are also responsible for 100% of any charges in excess of the reasonable and customary charge.

Dental

The dental plans offer a large network of contracting providers to choose from when dental care is needed. To find a preferred provider, visit metlife.com or call (800)942-0854. Reference the 'PDP Plus' network.

MetLife Dental PPO Plan

The MetLife Dental PPO Plan is a dental preferred provider organization (PPO). Each time you need care, you can visit any licensed dentist you choose. However, if you visit apreferred network provider, you save money since providers in the network charge negotiated rates. After you meet your annual deductible, the plan covers a percentage of the cost of your necessary care, up to the maximum annual benefit.

Yourcostfor the plan depends on the coverage you select (see Cost of Coverage below).

Select benefit design features are provided below.

Inside MetLife NetworkOut of MetLife Network
Choice of DentistLimited to MetLife NetworkAny dentist
Deductible Per individual: $60*

Annual Maximum

The most coverage that the Plan will provide you in one year.

Per individual: $1,500

Per family: Up to $3,000

Preventive Care

Two visits per calendar year

You pay 0%;

Plan pays 100%**

You pay 0%;

Plan pays 100%***

Basic Care
You pay 20%;

Plan pays 80%**

You pay 20%;

Plan pays 80%***

Major Care
You pay 50%;

Plan pays 50%**

You pay 50%;

Plan pays 50%***

Orthodontia
(Adult and Child)
You pay 50%;

Plan pays 50%**

Lifetime maximum per individual:$1,000
You pay 50%;

Plan pays 50%***

Lifetime maximum per individual:$1,000

*Deductible waived for Preventive and Orthodontia

**Payment for percentage of negotiated fees as determined by MetLife, subject to cost sharing, deductible and benefit maximums.

***Payment for percentage of reasonable and customary charges as determined by MetLife. You are responsible for 100% of any charges in excess of the reasonable and customary charge.

MetLife Dental Copay Plan

The MetLife Dental Copay Plan is a dental plan in which you make a copay based on a fee schedule, called the Procedure Charge Schedule. The Procedure Charge Schedule is based on the ZIP code where your dentist's office is located. Each time you need care, you can visit any licensed dentist you choose. However, if you visit apreferred network provider, you save money since providers in the network charge lower negotiated rates. If you visit an out-of-network provider you must meet an annual deductible, you pay a higher copay and your annual maximum benefit is reduced.

Metlife Dental Copay

Yourcostfor the plan depends on the coverage you select (see Cost of Coverage below).

Select benefit design features are provided below, including the copay percentage you may be asked to pay at the time dental services are rendered.

In-networkOut-of-network
Choice of DentistLimited to MetLife NetworkAny licensed provider
DeductibleNone

Per individual: $75*

Per family: Up to $225*

Annual Maximum

The most coverage that the Plan will provide you in one year.

Per individual: $5,000Per individual: $1,000

Preventive Care

One visit in a six month period.

You pay 10%;

Plan pays 90%**

You pay 30%;

Plan pays 70%***

Basic Care
You pay 30%;

Plan pays 70%**

You pay 60%;

Plan pays 40%***

Major CareYou pay 50%;

Plan pays 50%**

You pay 70%;

Plan pays 30%***

Orthodontia

(Adult and Child)

You pay 50%;

Plan pays 50%**

Lifetime maximum per individual: $1,500

You pay 60%;

Plan pays 40%***

Lifetime maximum per individual: $500

* Waived for orthodontia

** Payment for percentage of negotiated fees as determined by MetLife, subject to cost sharing, deductible and benefit maximums.

***Payment for percentage of reasonable and customary charges as determined by MetLife. You are also responsible for 100% of any charges in excess of the reasonable and customary charge.

Cost of Coverage

You pay the full premium for dental coverage based on:

  • The plan you choose and
  • The coverage level you choose (yourself only; yourself + spouse; yourself + child(ren); yourself + family)

Your cost is automatically deducted from your paycheck before income taxes are withheld. The premium may be adjusted each year.

Metlife Dental Hmo Copay

These rates are effective January 1, 2021.

MetLife Dental Copay PlanMetLife Dental PPO Plan
Yourself Only$29.67$42.30
Yourself + Spouse/Partner$49.14$75.78
Yourself +Child(ren)$56.83$95.16
Yourself + Family$78.47$150.02




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