MetLife Dental

Association Dental Plan Launches Open Enrollment

NCRGEA recently announced open enrollment for the MetLife Dental Plan.  In a move that may never be duplicated by any other healthcare insurance company, MetLife is not only lowering rates 18% across the board, but also adding benefits to the coverage.  Effective January 1, 2008, new benefits covered will include both implants and oral cancer screening.

When you consider how important good oral health is to your general health, your need for good dental benefits should not be ignored.  MetLife has offered dental insurance coverage for over 40 years and is the single largest dental plan administrator among single commercial carriers in the U.S., currently serving nearly 21 million people. MetLife’s Preferred Dentist Program (PDP) network is one of the largest in the industry, exceeding 100,000 participating dentist locations and over 22,000 Specialist locations nationwide.

Being enrolled in the MetLife PDP plan means lower out-of-pocket expenses when you visit a PDP dentist.  Whether or not the service is covered by your plan, you will always receive the MetLife PDP negotiated fee.  The negotiated fee is typically 10-35% less than the average fees charged by a dentist in your same community.

In North Carolina there are nearly 1,000 General Dentists and almost 200 Specialists in the MetLife PDP Network.  Those members living or traveling outside the state of North Carolina will be able to visit any participating dentist in the MetLife PDP nationwide network.  Of course, as always, you have the freedom of choice to visit any dentist, in- or out-of-network.

Preventive - all procedures covered at 100%*
Oral Exams - 2 per calendar year
cleanings - 2 per calendar year
topical fluoride application - 1 per calendar year (child & adult)
bitewing x-rays - 1 set per calendar year
full mouth x-rays - 1 per 60 months
palliative (emergency) treatment
space maintainers - 1 per lifetime per area up to age 19
sealants - once per 60 months up to age 19
Oral cancer screening

Minor restorative - All procedures covered at 60%*
amalgam restorations (fillings)
resin restorations (fillings)
crown and bridge repairs
perio scaling/root planing - 1 per 24 months per quadrant
perio maintenance therapy - 4 per calendar year, include 1110
perio surgery - once per quadrant every 36 months
simple and surgical extractions
oral surgery - some limits apply (see Certificate)
Endodontics/root canals - Once per tooth per 24 months
general anesthesia - when dentically necessary or in connection with complex surgery; max up to 2 hours
consultations - 1 per 12 months

Major restorative/dentures - all procedures covered at 50%*
bridges - replace once every 5 years
dentures - replace once every 5 years**
denture repairs
adjustments to dentures**
denture relining and rebasing**
tissue conditioning
crowns - 1 per tooth every 5 years
implants - once every 5 years per tooth

* Percentages of usual & customary fees
** Relining or Rebasing of existing Removable Dentures will be a covered dental expense not more frequently than once every 36 months (covered only after a minimum of six months after the initial installation of the device.)

NCRGEA members can view claims information and find a participating dentist via the metlife MyBenefits website (www.metlife.com/mybenefits).

NCRGEA  members currently enrolled in the MetLife dental plan do not need to reenroll for the 2008-2009 guaranteed rate period. No action on your part is necessary unless you wish to make a change in your coverage. If so, please use the change form enclosed with your letter and return it by November 9, 2007.

NCRGEA members not currently enrolled in the MetLife Dental Plan have been mailed an enrollment package offering you the option to join. We do not have access to your Retirement System files so when we mailed the enrollment package to you, we had no way of knowing if you are currently enrolled in another dental plan. For example, there is a dental plan offered by the Department of State Treasurer through United Healthcare Dental (formerly the NPD plan).  

If you wish to enroll in the MetLife plan and are having a premium deducted from your retirement benefit check for dental insurance, double check to see if the deduction appears on your payment voucher as NPD/SINS.  If so, you would need to cancel that plan by the end of their open enrollment period. If you do not cancel the NPD plan, there will be two dental premium deductions monthly beginning December 2007.

As the sponsor of the MetLife plan, NCRGEA receives no money from MetLife. We sponsor this plan strictly as a benefit to our members so we will be happy to discuss the differences between the two plans with you. However, you will need to decide which is the better plan for your needs.

If you would like additional information regarding the MetLife Dental Plan or have not received either of the mailings described in this article, please contact us at 1-800-356-1190 or info@ncrgea.com.