Preferred Dentist Program is the name MetLife gives to its Dental Preferred Provider Organization (PPO) product. The PDP plan provides benefits for a broad range of covered services/procedures, giving you the flexibility to choose any licensed dentist, in or out-of-network. MetLife’s PDP network allows you to choose from a large number of dentists and oral care specialists to find the right provider for you and your family.

Similar to other benefits, the programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations, and terms for keeping them in force. Contact MetLife for details by calling 1-866-832-5756 and press “0” or say “operator” when prompted for your member ID or SSN.  You may be asked for your member ID or SSN one more time, press “O” again or say “operator” again and a live person will come on the line. Our call center hours of operation are Monday-Friday 8AM to 11PM EST. Starting on January 1, 2024 you can access your plan details online by creating an account at www.metlife.com/mybenefits. 

Group dental plans featuring the Preferred Dentist Program are provided by Metropolitan Life Insurance Company, New York, NY.

You do not have to use a dentist in MetLife’s PDP network. However, there may be advantages to doing so:

• Expansive network of dental providers
• Potentially increased savings when you stay in-network¹; MetLife’s negotiated fees at savings of 35-50% off dentist list prices²
• No paperwork since the network dentists submit your claims directly to MetLife
• Preventive care covered 100% in-network³

Yes. You are always free to select the dentist of your choice. However, if you choose a non-participating dentist, your out-of-pocket costs may be higher.

There are thousands of general dentists and specialists to choose from nationwide — so you are sure to find one who meets your needs. To locate a PDP dentist, go to our Find a Dentist site, from there select “PDP” from the provider drop down, enter your ZIP code and click on the find button.

No, under the MetLife Preferred Dentist Program, you do not need to pre-select a participating provider before receiving care. You can decide whether to use a network provider at the point of service. Covered dependents can use a different network provider than the one you use.

When switching dental carriers, you may worry about what will happen if you have dental care that’s in progress. Some of the most common services—such as braces, root canals, and crowns—are ongoing treatments that could be affected if there is a change in dental carriers. Here is how MetLife will handle care that’s in progress:

Endodontic Treatments⁶

Root Canal: A tooth opened prior to, but completed after the MetLife dental plan effective date will be considered an eligible expense under the MetLife dental plan.

Prosthodontic Treatments⁶

Crowns and Bridgework: Treatment (preparation and impressions) started prior to, but placed after the MetLife effective date will be considered an eligible expense under the MetLife dental plan.

Partial or Full Dentures: Final impressions for appliances completed prior, but delivery made after the MetLife effective date will be considered eligible expenses under the MetLife dental plan subject to MetLife plan frequency limits.

For Endodontic and Prosthodontic treatment, please note that MetLife assumes that the dentist is using the completion date (not the preparation date) as the billing date. Based on this assumption, claims received with dates of service (completion dates) prior to the MetLife effective date will be declined.

Orthodontia Treatment

For orthodontia services, there are two key steps — obtaining payment history and treatment plan information. We’ll apply this payment and treatment information to the covered person’s MetLife PDP dental plan.

We ask that the dental office submit a claim to us after the covered participant’s effective date of coverage begins. We’ll then pro-rate the benefits and pick up payments. This process helps ensure the total benefit paid between the two carriers does not exceed the lifetime orthodontia maximum under the MetLife dental PDP plan.

1. Payment history: Information will be obtained the following ways:

a. History from your prior carrier will provide us the amount that has been paid towards the lifetime orthodontia maximum.

b. Your dental office will provide the payment history, as follows: once the plan is effective and we receive an orthodontia claim with banding dates prior to the effective date of coverage, we’ll deny the claim pending the following information from the dental office (to determine plan benefits):

• total orthodontic treatment fee
• amount paid by the prior carrier
• date the appliance was placed
• total number of estimated months of treatment
• orthodontic appliance code from the current American Dental Association (ADA) Common Dental Terminology (CDT) manual.

2. Treatment plan: In order for participants to receive benefits from MetLife for services rendered after the effective date, the first submitted claim must include the following information:

• name of dentist
• assignment of benefits
• date the appliance was placed
• total orthodontic treatment fee
• total number of estimated months of treatment

For “New hires” or added dependents after the effective date that have orthodontia treatment in progress, the total benefit payable under the MetLife plan will be determined based on the lifetime orthodontia maximum under the MetLife dental plan minus the estimated value of service rendered prior to the participant’s effective date. The remaining benefit will be considered over the course of treatment.

MetLife sets the value of services rendered by subtracting the benefit amount MetLife would have paid for the treatment rendered prior to the MetLife effective date from the maximum benefit for the entire treatment (up to the MetLife lifetime orthodontia maximum).

Yes. If your current dentist does not participate in the PDP network and you would like to encourage him or her to apply, ask your dentist to visit www.metdental.com or call 1-866-PDP-NTWK for an application. The website and phone number are for use by dental professionals only. Due to contractual requirements, MetLife is prevented from soliciting certain providers.

No. You do not need an ID card to receive dental services. However, all members will receive an ID card as part of the transition to MetLife. ID cards will have the member name on them only. If you have a covered spouse and/or dependent(s) enolled their name will not appear on the dental ID card. This ID card will remain good for as long as you are enrolled in the PDP plan administered by MetLife. New cards will not be sent each year. If your card is lost or damaged, you can obtain a replacement card by logging onto www.metlife.com/mybenefits and printing one.

Most services are covered at 100% when you visit an in-network dentist up to the plan maximum. Please see review your PDP Plan Summary for coverage details.

Dentists may submit your claims for you which means you have little or no paperwork. You can track your claims online and even receive e-mail alerts when a claim has been processed. If you need a claim form download one here or request one by calling 1-866-832-5756.

Yes. You can ask for a pre-treatment estimate. Your general dentist or specialist usually sends MetLife a plan for your care and requests an estimate of benefits. The estimate helps you prepare for the cost of dental services. We recommend that you request a pre-treatment estimate for services in excess of $300. Simply have your dentist submit a request online at www.metdental.com or call 1-877-MET-DDS9. You and your dentist will receive a benefit estimate for most procedures while you are still in the office, detailing an estimate of what services MetLife will cover and at what payment level. Actual payments may vary depending upon plan maximums, deductibles, frequency limits and other conditions at time of payment.

You can reach MetLife’s call center by dialing 1-866-832-5756. Our automated system is available 7 days a week to confirm eligibility, order claim forms, or request dentist directories. MetLife uses a conversational IVR system that uses voice commands from callers, allowing you to engage with a self-service model. This system is smart and intuitive enough to understand the context and content of your conversation. To speak to a live Customer Service Consultant, hours of operation are Monday-Friday 8AM to 11PM EST.

Yes. Starting on January 1st, you’ll be able to use MetLife’s MyBenefits portal and have mobile access to find:

• in-network dentists;
• Review your plan details;
• Download digital ID cards;
• Check the status of claims and payments for you and any covered family member; and
• Set communication preferences on how to receive notifications from MetLife.

If you have not already, you will need to register on MyBenefits in order to use this online tool. To register:

1. Log into www.metlife.com/mybenefits

2. Enter Uniformed Firefighters Associations (UFA) and select “next”

3. Select “register now” if you are not already a registered MyBenefits user

4. Upon login, select “MyAccounts”

5. Select the "Dental tile"

Yes. Through international dental travel assistance services⁴, you can obtain a referral to a local dentist by calling +1-312-356-5970 (collect) when outside the U.S. to receive emergency or immediate care until you can see your dentist. Coverage will be considered under your out-of-network benefits.⁵ Please remember to hold on to all receipts to submit a dental claim.

International dental claims should be faxed to our processing center at 859-389-6505 or mail to:

MetLife Dental Claims

P.O. Box 981282

El Paso, TX 79998

Coordination of benefits provisions in dental benefits plans are a set of rules that are followed when a patient is covered by more than one dental benefits plan. These rules determine the order in which the plans will pay benefits. If the MetLife dental benefit plan is primary, MetLife will pay the full amount of benefits that would normally be available under the plan. If the MetLife dental benefit plan is secondary, most coordination of benefits provisions require MetLife to determine benefits after benefits have been determined under the primary plan. The amount of benefits payable by MetLife may be reduced due to the benefits paid under the primary plan, but the two plans may work together to provide up to 100% coverage. For more information, contact MetLife’s Dental Service Center.

This is the total amount the plan will pay in the plan year. Once this amount is reached, no further benefits will be paid. The Annual Maximum for UFA’s PDP option is $2,500 per individual. Claims for Preventive services to not count towards your annual maximum.

The Orthodontia Lifetime Maximum is the total amount the plan will pay for orthodontic services for each covered person (subject to plan age limitations). Once this amount is reached, no further benefits will be paid. This does not affect your Annual Maximum Benefit for non-Orthodontia services like Preventive, Basic Restorative, and Major Restorative services.

Yes. The PDP plan contains a Missing Tooth exclusion that goes by the member’s hire date. If a tooth was extracted while you are covered by UFA, then it would be considered for benefits. If the tooth was extracted prior to being covered by UFA, then services to replace it would not be covered by this plan.