Dental Benefits
Metropolitan Life Insurance Company
Overview of Benefits for: ALFRED STREET BAPTIST CHURCH The Preferred Dentist Program was designed to help you get the dental care you need and help lower your costs. You get benefits for a wide range of covered services — both in and out of the network. The goal is to deliver affordable protection for a healthier smile and a healthier you.
In-Network: % of Negotiated Fee
Out-of-Network: % of R&C Fee 1
Coverage Type
Type A
100%
100%
Type B
100%
80%
Type C
60%
50%
Orthodontia
50%
50%
Deductible: Individual/Family*
$50 (Type B & C)
$50 (Type B & C)
Annual Maximum Benefit: Per Individual
$3000
$3000
$1500
$1500
Orthodontia Lifetime Maximum: Per Individual
Ortho applies to Child Only (up to age 19)
Understanding Your Dental Benefits Plan
Take advantage of online self-
With the MetLife Preferred Dentist Program you can visit the dentist of your choice – an “in - network” dentist (a participating MetLife dentist) or an “out -of- network” dentist. • Plan benefits for in-network services are based on the percentage of the Negotiated fee – the fee that in-network dentists have agreed to accept as payment in full for covered services, subject to any co-payments, deductibles, cost sharing and benefit maximums. Negotiated fees are subject to change. • Plan benefits for out-of-network services are based on a percentage of the Reasonable and Customary (R&C) charge. If you choose a dentist who does not participate in the network, your out-of-pocket expenses may be higher, since you will be responsible for paying any difference between the dentist's fee and your plan's payment for the approved service. Please refer to the Selected Covered Services and Frequency Limitations page of this document for details regarding how R&C charges are defined under this plan.
Locate a participating dentist Access MetLife’s Oral Health Library
go to www.metlife.com/mybenefits
Certain plan benefits are based on a percentage of the negotiated fee. This is the amount that participating dentists have agreed to accept as payment in full. If your plan benefits are based on a percentage of the Reasonable and Customary (R&C) charges, your out-of-pocket expenses may be more, since you will be responsible for paying any difference between the dentist's fee and your plan's payment for the approved service.
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