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Dental - MetLife

Metropolitan Life Insurance Company Network: PDP Plus plan OPTION 1 Dental Plus plan OPTION 2 Dental Coverage Type In-Network % of Negotiated Fee* Out-of-Network% of R&C Fee** In-Network % of Negotiated Fee* Out-of-Network % of Scheduled Amount** Type A: Preventive (cleanings, exams, X-rays) 100% 100% 100% 100% Type B: Basic Restorative (fillings, extractions) 80% 80% 45% 45% Type C: Major Restorative (bridges, dentures) 50% 50% 30% 30% Type D: Orthodontia 50% 50% 50% 50% Deductible Individual $50 $50 $50 $50 Family $150 $150 $150 $150 Annual Maximum Benefit Per Person $1,500 $1,500 $1,500 $1,500 Orthodontia Lifetime Maximum Per Person $1,500 $1,500 $1,500 $1,500 Child(ren) s eligibility for Dental coverage is from birth up to age 26.

List of Primary Covered Services & Limitations Plan Option 1: Dental Plus Plan Plan Option 2: Dental Plan ... If the MetLife dental benefit plan is primary, MetLife will pay the full amount of benefits that would normally be available under the plan, subject to applicable law. If the MetLife dental benefit plan is secondary,

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  Services, Primary, Plan, Dental, Limitations, Covered, Metlife, Dental plan, Plan plan, Metlife dental, Primary covered services, Limitations plan

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