SGX85
Plan Effective Date: 01/01/2022Providers
Under the MetLife Dental HMO plan, members must choose a Primary Care Dentist (PCD) from the SGX85 contracted network of dentists. All covered services must be received or referred by the members' PCD.
Members can change their PCD at any time by contacting MetLife, but the plan can only be changed during the annual Open Enrollment or within 30 days of a qualifying life event.
How to Find a Dentist
Under “What type of information are you looking for” select “Find a Dentist”
Select “Dental HMO/Managed Care”
Enter your zip code or city and state, then click “Find a Dentist”
A pop-up window will appear with a drop-down menu
Select the SGX85 plan
Dentists within 25 miles of your zip code will appear
To find a specific Dentist or Practice Name, enter the information in the search field then click “Find”
To filter results by Language, Specialty, Distance, etc., select the options under the “Filter Your Results” drop-down box, then click “Apply”
Select a Primary Care Dentist and write down the 5-digit Facility Number, located under the provider’s name
New Hires: Login to / register on the Benefitfocus website and enter the 5-digit Facility Number when enrolling in MetLife Dental HMO coverage
Continuing Employees: Contact MetLife at (800) 880-1800 or log onto www.metlife.com/mybenefits to change your Primary Care Dentist
Out-of-Pocket Costs
The amounts that a member pays when utilizing services.
Deductible
AnnuallyNone
Cleanings
2 Times/Calendar Year$0 copay
Maximum Benefit
AnnuallyCopays vary
Based on service
Orthodontia
Adults & childrenCopays vary
Based on service
Implants
Not covered
Emergency Care
$0 copay
PCD Office$50 reimbursement
Out-of-area providerSee EOC for limitations & exclusions
Out-of-Area Services
Subscribers
In or Out-of-State
Emergency Care*
Out-of-Country
Emergency Care*
Dependent(s)
In or Out-of-State
Emergency Care*
Out-of-Country
Emergency Care*
