Dental Plans
DENTAL PLANS
Children’s Mercy provides dental coverage through MetLife. You may elect one of the following plans:
- PPO Plus
- Mid PPO
- Low PPO
All three dental plan choices provide coverage for:
- Preventive services (cleanings and X-rays); and
- Basic services (fillings, tooth extraction, root canals and most gum-related work).
When you use in-network providers, your dentist files claims for you. (Under Find a Dentist, select PDP from the Select your network drop-down.) When you use out-of-network providers, you may pay more and may have to file your own claims.
Here’s how the plans work:
| In-Network | Out-of-Network | In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Deductible | ||||||
| Maximum benefit (per person, per plan year, excluding orthodontia) | $2,000* | $1,000* | $1,250* | $500* | ||
| Preventive services | 100% | 80% | 100% | 80% | 100% | 80% |
| Basic services | ||||||
| Major services | ||||||
| Orthodontia | 50%, up to a separate $2,000 lifetime benefit** | 50% up to a separate $1,000 lifetime benefit** | ||||
* In-network maximum represents the most the plan will pay. If you use an out-of-network provider, the first $500 (Mid PPO) or $1,000 (PPO Plus) paid by the plan may be paid to an out-of-network provider. If the plan has already paid that amount to any provider, no out-of-network benefit is available.
** You must stay enrolled in the PPO Plus plan for the duration of your (or your dependent’s) orthodontic care to receive full orthodontia benefits.
