VA DENTAL INSURANCE PROGRAM (VADIP)

MetLife VADIP Dental Plan Benefit Options

Find out what the MetLife VADIP plans cover and decide on an option that's right for you.

Choose MetLife Benefits

With MetLife’s Veterans Affairs Dental Insurance Program, you have a choice of two plan options ‐ Standard and High. Both plans provide savings¹ for you and your family. We offer:

No waiting periods for major procedures (except for Orthodontia in high plan which has a 24‐month waiting period)
Competitive pricing
Discounted In‐Network Dentist fees

Please review the plan details below to help you decide on the option that best fits your needs.

Standard Option

$1,300/$1,500² in‐network annual maximum per person

No cost for in‐network cleanings, X‐rays and exams
No annual deductible for in‐network benefits

High Option

This option provides you with additional protection from unforeseen dental costs

$3,000/$3,500² annual plan maximum per person
Orthodontia coverage for dependent children up to age 19³
No cost for in‐network cleanings, X‐rays and exams
No annual deductible for in‐network benefits

What will your plan cover?

Coverage Option

Basic — Class A

cleanings, X-rays and oral examinations*

Intermediate — Class B

fillings and periodontal maintenance

Major — Class C

crowns, bridges, root canal treatment and dentures

Orthodontia – Class D

comprehensive orthodontic treatment, fixed appliance

Standard Option

In-Network

100%

50%

30%

Not Covered

Out-of-Network

60%

40%

20%

Not Covered

High Option

In-Network

100%

70%

50%

Out-of-Network

90%

60%

40%

50%

*Subject to frequency limitations available in the VADIP Plan Summary.

Maximums and Deductibles

Coverage Option

1st Year Annual Maximum/ Maximum Per Person

Dependent Child Ortho Lifetime Maximum Per Person

Annual Deductible Per Person

(Applies to Basic, Intermediate and Major Services)

Standard Option

In-Network

$1,300/$1,500*

Not Covered

$0.00

Out-of-Network

$1,000/$1,200*

Not Covered

$50.00

High Option

In-Network

$3,000/$3,500*

$3,000

$0.00

Out-of-Network

$3,000/$3,500*

$3,000

$50.00

*Increases on January 1st following completion of 12 months of enrollment in selected option.

Orthodontia and In vs Out-of-Network

Orthodontia

Orthodontia coverage is available for Dependents up to age 19³ who are enrolled in the High Option. The Dependent must be covered under the High option for 24 consecutive months before orthodontia benefits will be covered.

Please view the MetLife VADIP Plan Summary to view the covered services, exclusions and limitations.

In-Network

What will your dentist charge you? Participating dentists charge negotiated fees⁴ for covered services that are typically 30% to 45% less than average dental charges in the same community based on MetLife data. Negotiated fees may even apply to services your plan doesn’t cover, including any you’ve received after you reach your plans annual maximum as permitted by applicable law.⁴

Out-of-Network

What will your dentist charge you? A non-participating dentist sets his or her standard fee, which is typically higher than the negotiated fee. You will be responsible for the difference between your dentist's charge and the covered percentage of the Maximum Allowed Charge.⁵

¹ Savings from enrolling in a dental benefits plan will depend on various factors including the cost of the plan, how often participants visit a dentist and the cost of services rendered.

² The Annual Maximum will increase by $200 in the Standard Option, and by $500 in the High option on January 1st following completion of 12 months of enrollment in the selected option.

³ Adult orthodontia unavailable.

⁴ IN-NETWORK: Negotiated fees with participating dentists are typically 30% to 45% less than average dental charges in the same community based on MetLife data. Negotiated fees refer to the fees that participating (in-network) dentists have agreed to accept as payment in full for covered services rendered by them , subject to any deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. For in-network covered services, the percentages shown are the percentage of the negotiated fee that is covered by the plan. Negotiated fees may also apply to services your dental plan does not cover or services received after you’ve reached your annual plan maximum, depending on applicable law.

⁵ OUT-OF-NETWORK: Reimbursement for out-of-network services is based on the lesser of the dentist’s actual fee or the Maximum Allowable Charge (MAC). The out-of-network Maximum Allowable Charge is a scheduled amount determined by MetLife.

Like most group benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, reductions, limitations, waiting periods, and terms for keeping them in force. Please contact MetLife or view the VADIP Plan Summary for cost and complete details.

The service categories and plan limitations shown above represent an overview of your plan benefits. This document presents the majority of services within each category, but is not a complete description of the plan.

Negotiated fees refer to the fees that in-network dentists have agreed to accept as payment in full for covered services, subject to any co-payments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change.

MetLife VADIP Dental Plan Benefit Options

Choose MetLife Benefits

Standard Option

High Option

What will your plan cover?

Maximums and Deductibles

Orthodontia and In vs Out-of-Network

Orthodontia

In-Network

Out-of-Network

Our network of dentists and specialists

Quick Links

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