Dental

MetLife Dental Options

Covered services	Plan 1: Low Plan In-network and Out-of-Network* Progressive Plan	Plan 2: High Plan In-network and Out-of-Network* Progressive Plan
Calendar Year Maximum (Class I, II, III, IX Expenses)	$1,800 per covered member	$2,300 per covered member
Calendar Year Deductible Per Individual / Per Family	$50/$150	$50/$150
Class I Expenses: Preventive & Diagnostic Care Oral Exams, Cleanings, Routine X-rays, Fluoride Application, Sealants, Space Maintainers (limited to Non-Orthodontic Treatment, Non-Routine X-rays)	100% covered; no deductible	100% covered; no deductible
Class II Expenses: Basic Restorative Care Emergency Care to Relieve Pain, Fillings, Oral Surgery: Simple Extractions, Oral Surgery: All Except Simple Extraction, Surgical Extraction of Impacted Teeth, Anesthetics, Minor Periodontics, Major Periodontics, Root Canal Therapy / Endodontics, Brush Biopsy	80% after deductible	90% after deductible
Class III Expenses: Major Restorative Care Relines, Rebases, and Adjustments, Repairs: Bridges, Crowns, and Inlays, Repairs: Dentures, Crowns/Inlays/ Onlays, Stainless Steel/Resin Crowns, Dentures, Bridges	50% after deductible	60% after deductible
Class IV Expenses: Orthodontia Coverage for Eligible Children Only	50%; no ortho deductible	50%; no ortho deductible
- Lifetime Maximum	$1,000	$1,500
Class IX Expenses: Implants	50% after deductible	60% after deductible
- Plan Calendar Year Maximum	$1,800	$2,300

This Summary is for informational purposes only. For specific benefit information, please refer to the applicable Benefit Summary. The Benefit Summary contains exclusions and limitations that are not shown here.

2026 Dental Cost Per Pay

	Low Plan	High Plan
Employee Only	$16.90	$20.81
Employee + Spouse	$33.74	$41.89
Employee + Child(ren)	$41.08	$50.16
Family	$63.24	$75.45

You have a choice between two dental plans through MetLife: the Low Plan and the High Plan. These plans offer you the flexibility to see a provider of your choice each time you seek dental care. To find a network dentist online at www.metlife.com:

Select “Find a Dentist” next to “How can we help you.”
Select “PDP” for the Low Plan or “PDP Plus” for the High Plan next to “Choose your network.”
Enter your ZIP, City or State and select the “Find a Dentist” button.

Dental

MetLife Dental Options

2026 Dental Cost Per Pay

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