|
State of North Carolina
Department of Correction Plan Design
MetLife Dental Program
|
Emerging research is showing connections between oral health and medical conditions
such as heart disease and low birth weight in infants. Now, it is more important than
ever to consider your need for dental benefits. That's why State of North Carolina
Department of Correction is pleased to continue to offer access to a dental benefit
program made available from MetLife. With the plan, which features the MetLife
Preferred Dentist Program (PDP), you can get dental coverage with real advantages.
Dental coverage
designed for the real world
MetLife, an industry leader
for more than 40 years, offers easy-to-understand dental coverage that allows
you to:
Protect - you and your
family from the rising costs of dental care by providing coverage for
preventative, basic and complex services
that
help ensure long-term oral health.
Choose - any dentist you
want.
What you need,
when you need it
We're not
content to just provide you with great dental protection - we want you to have
a great experience. That's what MetLife's superior service committment is
all about. MetLife processes 85% of claims in five business days or less
to get your claim paid faster. And, if you have questions, simply call
1-800-942-0854 or log on to
www.metlife.com/mybenefits, to access all the tools and
information you will need to be a better-informed user of your dental plan.
|
|
MetLife Benefit Summary
|
|
Coverage Type: (click
here for Type A, B, C and D procedures)
Type A - Preventative
Type B - Basic Restorative
Type C - Major Restorative*
Type D - Orthodontia*
|
In-Network
100% of PDP Fee**
80% of PDP Fee**
50% of PDP Fee**
50% of PDP Fee**
|
Out-of-Network
100% of R&C Fee***
80% of R&C Fee***
50% of R&C Fee***
50% of R&C Fee***
|
Fees for 2008 Plan Year
Employee Only: $25.46
Employee + Spouse: $49.99
Employee + Child(ren): $50.40
Employee + Family: $81.66
|
Deductible****
Individual
Family
|
In-Network
$25
$75
|
Out-of-Network
$25
$75
|
Fees will be in effect from
January 1, 2008 through
December 31, 2009 |
Annual Maximum
Benefit
Per Person
|
In-Network
$1500
|
Out-of-Network
$1500
|
|
Orthodontia
Lifetime Maximum:
Per Person
|
In-Network
$1500
|
Out-of-Network
$1500
|
|
* For Late Entrants there is a 12 month wait for these services.
** PDP Fee refers to the fees that participating dentents have agreed to accept as payment in full.
*** Reasonable & Customary
charges are based on the research of a dentist's usual, actual & community
average charge as determined my MetLife.
**** Applies only to Type B & C Services. |
|
|
The MetLife Dental Program
Gives You:
|
|
Multiple self-servicing channels to get the information you need when you
need it.
Visit our website at www.metlife.com/mybenefits
to:
-
Verify your eligibility and download a copy of your plan design.
-
View a list of your covered dependants. Dependants will not be listed by
name in all cases, only by coverage type,
for example, Employee Only, Employee plus Children, etc.
-
Get real-time benefit estimates in your dentist's office.
-
Get treatment faster because your dentist can submit your claim form
electronically.
-
Access pending claim status or review claim history online or over the phone.
-
Track claims online and receive email alerts when a claim has been processed.
Or, call us at 1-800-942-0854
|
|
3 Easy Steps to Optimize
Your Dental Benefit
|
-
Avoid surprises by asking your dentist to submit a
pre-treatment estimate. While you wait, your dentist can get a real-time
pre-treatment estimate online or over the phone in minutes detailing what your
plan will cover and at what payment level.
-
Take advantage of your plan's preventative care benefit
(Type A) to help avoid more costly procedures later.
-
Keep the plan overview for future reference and provide
a copy to your dentist when you visit.
Like most group dental policies, MetLife policies
contain certain exclusions, waiting periods, reductions, limitations and terms
for keeping them in force.
Please contact MetLife for complete details.
|
