Regarding MetLife dental coverage - Is it capitated or fee for service?!


Question: I know they make fee for service and PPO plans (a PPO plan is one with a panel of participating dentists. They contractually agree to accept Metlife's fee schedule. Deductibles, yearly max. benefits and copays usually apply. You can get a benefit from any dentist, but as PPO fee schedules are generally reduced there will be less out-of-pocket expense if you go to a participating dentist.
I don't know if they write capitation plans, but I'm thinking they must, as most of the big insurance companies do.
Personally, I'd have nothing to do with a capitation plan.

Steve Bornfeld, DDS


Answers: I know they make fee for service and PPO plans (a PPO plan is one with a panel of participating dentists. They contractually agree to accept Metlife's fee schedule. Deductibles, yearly max. benefits and copays usually apply. You can get a benefit from any dentist, but as PPO fee schedules are generally reduced there will be less out-of-pocket expense if you go to a participating dentist.
I don't know if they write capitation plans, but I'm thinking they must, as most of the big insurance companies do.
Personally, I'd have nothing to do with a capitation plan.

Steve Bornfeld, DDS





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