MetLife dental PPO cover in Costa Mesa CA

Metlife Dental has the following dental coverage plans available: PPO-low, PPO-medium, and PPO-high.

MetLife dental plans coverage

You have the option to select any board-certified dentist, in or out of network, with MetLife PPO plans since they offer benefits for a wide range of covered oral care and dental procedures. Preventive care is typically fully covered in-network by MetLife PPO plans, which also offer an extensive network of dental providers, greater savings when you stay in-network, no paperwork; in- or out-of-network dentists who submit your claims, and convenient service via MetLife’s secure member website.

MetLife Dental PPO – Low

With the MetLife dental PPO-low plan, members can have estimated 100% or full coverage on diagnostic services and preventive care including oral exams, bitewing x-rays for both adults and children, fluoride treatment, and teeth cleanings with no waiting period. Coverage for basic restorative services, such as full mouth x-rays, dental sealants, teeth fillings, and tooth extractions, are estimated 50% with a 6 month waiting period.

MetLife Dental PPO – Medium

You can have estimated 100% coverage on preventive oral care and diagnostic services, such as dental exams, dental cleanings, fluoride, and bitewing x-rays for both children and adults with no waiting period under MetLife dental PPO-medium plan. With MetLife dental PPO-medium plan, estimated 70% are covered for basic restorative services like sealants, full-mouth x-rays, tooth fillings, as well as extractions and there’s a 6 month waiting period. Major restorative services including inlays, porcelain onlays, dental crowns, root canals, dentures, bridges, and dental implants have a estimated 50% coverage with a 12 month waiting period.

MetLife Dental PPO – High

MetLife dental PPO-high plan covers estimated 100% of your preventive dental care and diagnostic services with no waiting period. These include professional cleanings, oral exams, fluoride treatment, and bitewing x-rays for both children and adults. The coverage for basic restorative services like dental sealants, full-mouth x-rays, dental fillings, and tooth extractions is estimated 80% with a 6 month waiting period. With MetLife dental PPO-high plan, major restorative services namely porcelain onlays, dental inlays, root canals, crowns, dental bridges, dentures, and dental implants have a estimated 50% coverage with a 12 month waiting period. The program pays estimated 50% up to $1,000 for orthodontic services for children while the orthodontic services for adults are not covered.

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MetLife Dental tooth extraction cost cover?

According to MetLife Dental, estimate of 50% – 80% of simple extractions are covered for both in- and out-of-network based on the maximum allowed charge. Deductibles for simple tooth extractions are $75 for calendar year individual deductible and $225 for calendar year family deductible. The maximum benefit is $750 for a calendar year individual maximum. Simple extractions will be covered after a waiting period of 6 months. Source

MetLife dental coverage Wisdom teeth removal?

Wisdom teeth removal is covered by MetLife Dental as part of their routine oral care benefits. Most of the time, MetLife Dental will pay up to estimate of 50% of the price of having your wisdom teeth removed. This covers the cost of the procedure itself as well as any required follow-up visits or dental x-rays. However, you may have to pay a deductible before your insurance coverage pays a part of your treatment cost. Make sure to ask your insurer what exactly you would be expected to spend out-of-pocket. Source

Does MetLife dental covers X-Rays?

With MetLife Dental, bitewing x-rays for both adults and children are fully or estimated 100% covered with no waiting period. Bitewing dental x-rays for children are covered once every 6 months while adults are covered one time in a calendar year. On the other hand, full mouth x-rays are estimate of 50%-80% covered with a 6 month waiting period. One set of full-mouth x-rays is covered in 60 consecutive months. Source

MetLife Dental cover Braces?

MetLife Dental PPO-high plan pays estimated 50% for orthodontic services such as braces for children up to age 19. The lifetime individual maximum is $1,000 with a 12 month waiting period. On the other hand, braces for adults are not covered. Source

Is Invisalign cover by MetLife Dental?

Invisalign is covered by MetLife, but only if your insurance plan’s contract specifies orthodontic benefits. MetLife Dental PPO-high plan pays estimated 50% for orthodontic services like Invisalign for children up to 19 years old. The lifetime individual maximum is $1,000 and the waiting period is 12 months. Invisalign for adults is not covered. To ensure that Invisalign is a covered benefit in your plan, read the insurance policy’s fine print. Source

What does MetLife dental accepts for dental implant?

With MetLife dental PPO, major restorative services including dental implants have a estimate of 50% coverage with a 12 month waiting period. Dental implant surgical placement services are typically limited to one per year, with replacement services occurring once per 10 years. Dental implant supported prosthetics are limited to once every 10 years. In the event that an implant crown becomes unusable and cannot be fixed, replacement is typically limited to every 5 years. Source

Does MetLife Dental accepts dentures?

Dentures are covered by MetLife Dental PPO. About estimated 50% are covered with a 12 month waiting period. Be aware that your plan can include a deductible, a waiting time before you qualify for some procedures, and an annual maximum (the most that MetLife will pay out without a calendar year). Denture replacement is limited to once every 10 years. Source

How much does MetLife dental cover for Veneers?

Unfortunately, elective cosmetic dentistry treatments like dental veneers are not covered by MetLife Dental plans. Nonetheless, even replacement of tooth fillings and crowns are typically covered even if done for mostly aesthetic reasons. Source

MetLife dental coverage for Gum Grafts?

MetLife PPO covers estimated 50% of periodontal surgeries such as gum graft surgeries. Periodontal surgery like gum graft surgery is limited once per quadrant or area, in any 36 consecutive month period. Source

Does MetLife Dental cover Tooth Filling and Cleaning

MetLife dental PPO offers full coverage of dental prophylaxis or teeth cleaning once every 6 months with no waiting period. MetLife dental PPO plans also provide coverage of about estimate of 50%-80% of amalgam and resin composite fillings with a 6 month waiting period. It is limited to one per tooth surface every 24 consecutive months. Source

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DISCLAIMER: This information is subject to change on behalf of the insurance company. We are providing this as an informal guide to help you determine which services at our office are covered by your insurance. For more detailed information, please see the insurance company’s website or call the customer service or member services number listed on most insurance ID cards. Updated as of 3/27/2023. The above logo & trademarks are property of MetLife Dental.

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