Frequently Asked Questions About MetLife’s DHMO Plan

FAQs
 
How does a DHMO plan work?

With a DHMO plan, you choose a dentist to be your primary care dentist. You will have to pay a co-payment for each treatment you have from your chosen dentist. You’ll receive a ‘Schedule of Benefits’ that lists everything that is considered to be a covered service. It also shows information on limitations, additional charges for certain procedures, and what might not be covered by your plan.

Do I need to select a dentist who participates in the network when I enroll?

Yes. When enrolling, you will need to choose two participating dentists. This will make sure you’re able to receive care as soon as your plan begins.

What if the dentist I want to choose is listed as ‘closed’ in the MetLife directory?

‘Closed’ means that dentist is not accepting new patients. However, if you are already a patient with a dentist listed as ‘closed’ in the MetLife Directory, it may be possible that you won’t have to change. Contact Customer Service to find out if it is possible to continue seeing your regular dentist.

What if I want to change dentist?

You and your family can each choose different participating dentists. You can also change dentists as often as once a month. To change dentists go to www.metlife.com/mybenefits. Your transfer will be effective on the first day of the month after you request the change.

What if I need emergency care?

All participating dental offices in our network provide emergency care 24 hours a day, 7 days a week. If you are unable to reach your selected primary care dentist, you can receive emergency care from any licensed dental care professional.

What if I need to see a specialist?

You will need a ‘direct referral’. Your primary care dentist will refer you to a participating specialist in your area. You won’t have to wait for approval. The co-payment amount for the treatment you need will be listed on your Schedule of Benefits.

How can I find out what my out-of-pocket costs will be?

You can either ask your primary care dentist or you can contact the MetLife customer service number listed on your ID card.

Can anyone get a DHMO plan?

No, DHMO is not available in all states. Currently, MetLife offers DHMO in California, Florida, New Jersey, New York and Texas.

 

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