DENTAL OPTIONS
Coverage for necessary dental care is automatically included for those enrolled in any Health Care Plan offered by the Diocese of Cleveland. The coverage is also available as a stand alone benefit for eligible participants. Participants can choose between the Standard Dental, PPO or High Option PPO Plans. (Dental coverage is not automatically included if you are enrolled in the Medicare Advantage plan.)
The Standard Dental Plan
Is not a preferred provider program and allows you to use any licensed dental provider. As an added feature of this Plan, MetLife provides advantages when using one of their network providers, including negotiated discounts for non-covered services or after your annual/lifetime maximums have been reached (subject to state approval). Additionally, you are guaranteed not to be balance billed for charges in excess of the negotiated fee when using a MetLife network provider. To locate a participating MetLife provider, you can call 1-800-942-0854 or access the MetLife Provider Finder at www.metlife.com.
RESOURCES
The PPO Dental Plan
is a preferred provider dental program which allows you to receive a higher level of benefits when utilizing a dentist in the MetLife network. You are not required to sign up with a Primary Care Dentist (PCD) in order to receive services, and no ID card is required. However, you must use a dentist in the MetLife network in order to receive the highest level of benefits. This program also provides you with no balance billing from the MetLife network providers.
The High Option PPO Dental Plan
Provides benefits in the same manner as the PPO Dental Plan. Members are able to purchase a higher level of benefits for a monthly contribution.
Note: Certain procedures are considered to be surgical, such as impacted wisdom teeth and osseous surgery, and may be covered under your medical plan rather than the dental plan.
Comparison chart
| STANDARD PLAN | PPO PLAN | HIGH OPTION PPO PLAN (BUY-UP) | |||
| IN-NETWORK | OUT-OF-NETWORK | IN-NETWORK | OUT-OF-NETWORK | ||
| Annual Maximum | $750 | $1,000 | $1,250 | ||
| Deductible | $50 Individual / $150 Family | $100 per Individual | $50 Individual / $150 Family | ||
| Dependent Child Maximum Age | Age 26 removal month end | Age 26 removal month end | Age 26 removal month end | ||
| Emergency Palliative Treatment | 80% traditional amount | 100% | 100% | ||
| Preventive Services (Annual Cleanings, Exams & Bitewing X-Rays, etc.) | 80% traditional amount (No Deductible) | 100% (No Deductible) | 50% traditional amount | 100% (No Deductible) | 50% traditional amount |
| Essential Services (Fillings, Root Canals, Extractions) | 50% traditional amount | 70% | 50% traditional amount | 80% | 50% traditional amount |
| Periodontal Surgery | 50% traditional amount | 70% | 50% traditional amount | 60% | 50% traditional amount |
| Complex Services (Crowns, Partials) | 50% traditional amount | 60% | 50% traditional amount | 60% | 50% traditional amount |
| Orthodontia (dependent Children only to the age of 19) | 50% traditional amount ($100 Deductible) | 60% (No Deductible) | 50% ($100 Deductible) | 60% (No Deductible) | 50% (100% Deductible) |
| Orthodontia Lifetime Max | $750 | $750 | $750 |
