Transcription of Dental PPO Summary of Benefits - MetLife
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Dental PPO Summary of Benefits - MetLife
District School Board of Pasco County PPO Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Core PPO Plan Voluntary (Opt-Out) PPO Plan Coverage Type In-Network: Out-of-Network: Coverage Type In-Network: Out-of-Network: Type A cleanings, oral examinations 100% of PDP Fee* 80% of R&C Fee** Type A cleanings, oral examinations 100% of PDP Fee* 80% of R&C Fee** Type B fillings 90% of PDP Fee* 80% of R&C Fee** Type B fillings 90% of PDP Fee* 80% of R&C Fee** Type C bridges and dentures 60% of PDP Fee* 50% of R&C Fee** Type C bridges and dentures 60% of PDP Fee* 50% of R&C Fee** Type D orthodontia 50% of PDP Fee* 50% of R&C Fee** Type D orthodontia 50% of PDP Fee* 50% of R&C Fee** TMJ 50% of PDP Fee* 50% of R&C Fee** TMJ 50% of PDP Fee* 50% of R&C Fee** Deductible : In-Network Out-of-Network Deductible.
General Anesthesia •When dentally necessary in connection with oral surgery, extractions or other covered dental services. Oral Surgery Oral Surgery Periodontics •Periodontal scaling and root planing once per quadrant, every 24 months. • …
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