MetLife Dental Insurance in Katy

Reading a MetLife dental card

MetLife dental PPOs are often labeled PDP or PDP Plus. Those are different networks with different fee arrangements. A federal dental enrollment through MetLife is another contract, with its own brochure. The safe step is the same in every case: we read the card and verify, rather than quote "the MetLife rate."

Dentality Family Dentistry accepts MetLife dental insurance and files the claim for you. If your card assigns a primary dentist, the way a DHMO does, tell us before the appointment so we can confirm this office is able to bill it.

PDP and PDP Plus are both MetLife, and they are not billed as if they were the same network. The words under the logo are what we verify. A federal dental enrollment through MetLife is a third contract, with its own brochure, and we confirm that one from the card as well.

What we check

We look up active coverage, the remaining annual maximum, the deductible, and coinsurance by class of service. MetLife groups commonly cover preventive care more fully than major care. Downgrades are worth knowing about: some plans pay a tooth-colored filling on a back tooth as if it were a metal filling and leave the difference to you. If that applies to your group, we say so before the filling, not after the explanation of benefits arrives.

Implants, bridges, and adult orthodontics are verified one by one. A high annual maximum does not mean those services are included.

If a second dental plan also covers you, bring both cards. MetLife may be primary or secondary depending on the birthday rule or which employer plan started first. Billing them in the wrong order delays both payments.

What to bring

MetLife downgrades on back-tooth fillings are common enough that we check them before treatment. If your group pays a tooth-colored filling only up to the metal-filling allowance, the difference is explained before we restore the tooth.

• The MetLife dental card showing the network name
• Member ID and group number
• Subscriber details if the plan is through a spouse or parent
• Notice of any other dental plan, so we can coordinate benefits in the right order

Coordination and claims

If you have MetLife and a second dental plan, we need both cards. The birthday rule or the employer rule decides which plan pays first. We will not bill them in the wrong order and create a delay.

We submit the MetLife claim and send follow-up records if asked. Your estimated share is discussed first. Other plans we accept are on the insurance and financing page.

A high annual maximum does not mean implants or adult orthodontics are included. Those are separate lines. We look them up when they are the reason you called, and we will say if the maximum never applies because the service is excluded.