MetLife Dental PPO Missing Tooth Clause, Limitations, Exclusions, and Frequencies

MetLife Dental has one of the most extensive, nationwide networks of licensed dentists and specialists. Many employers select MetLife Dental PPO plans for their employees. Individual policies may also be purchased from the MetLife Dental PPO insurance company.

There are many types of plans available, but each plan has its own coverage rules. For those who don’t regularly work with insurance companies, these rules may be hard to understand. Sunnyvale Dentist Dr. Antonious and his team at Sunnyvale Dental Care have been working with insurance companies for many years.

When you schedule an appointment at Sunnyvale Dental Care, they will contact MetLife Dental PPO insurance for you and get the coverage details for your plan.

It is common for most dental insurance companies to regulate how often their members use their coverage. This is a frequency limitation. For example, some companies allow their members to receive cavity detecting bitewing x-rays every six months with their cleanings and periodic exams. Other companies only allow these x-rays to be taken once per year

There are usually multiple treatment options available for different dental conditions. Some insurance companies will refuse to pay for certain treatments but are willing to cover less expensive solutions. An example is dental implants. Although it is now common for several insurance plans to cover dental implants, for many years this type of treatment was excluded from most insurance policies. Why? Because less expensive replacement options like dental bridges, and partial dentures were available. Now that dental implants have increased in popularity and the benefits are well known, more and more insurance plans are including them as a covered benefit.

One of the newest rule to be established by some but not all insurance companies is the missing tooth clause. This clause excludes any dental treatments used to replace missing tooth that were extracted before the dental insurance policy went into effect. This clause can negatively impact many people and cause them to have much higher patient copays. When shopping for an insurance policy, it is best to choose one that does not have a missing tooth clause.

Sunnyvale Dentist Dr. Antonious welcomes you to his practice and is committed to helping you maintain your dental health while getting the most benefit from your dental insurance plan.