Submitting a dental claim to MetLife doesn't have to be a headache! In fact, with a bit of guidance, you'll find the process quite straightforward. Whether you've just had a routine cleaning or a more extensive procedure, understanding the steps involved will help you get reimbursed quickly and efficiently.
Ready to dive in and take control of your dental benefits? Let's get started!
Step 1: Understand Your MetLife Dental Plan
Before you even think about submitting a claim, it's crucial to know the ins and outs of your specific MetLife dental plan. Policies vary greatly, and what's covered for one person might not be for another.
Sub-heading: Review Your Benefits
- Policy Booklet/Summary Plan Description (SPD): This is your go-to resource. It outlines your coverage, deductibles, annual maximums, co-insurance, waiting periods, and any exclusions. If you don't have a physical copy, check your employer's benefits portal or the MetLife website for a digital version.
- Covered Procedures: Understand which dental procedures are covered (e.g., preventive, basic, major, orthodontic) and at what percentage. For instance, preventive care (cleanings, X-rays) is often covered at 100%, while major procedures (crowns, bridges) might be covered at 50%.
- In-Network vs. Out-of-Network: MetLife offers various plans, including PPO options. If you visit an in-network dentist, the claim process is typically smoother as they handle most of the paperwork and often have pre-negotiated rates. If you go out-of-network, you might pay more upfront and be responsible for submitting the claim yourself.
- Deductibles and Annual Maximums: Be aware of your deductible (the amount you pay out-of-pocket before your insurance starts paying) and your annual maximum (the total amount your plan will pay in a given year).
Sub-heading: When Does Your Dentist Handle It?
For many MetLife plans, especially PPO plans, your dentist's office will automatically submit the claim on your behalf. This is the easiest scenario for you! They have the necessary software and experience to file the claim directly with MetLife.
- Confirm with Your Dentist: Always ask your dentist's office if they will submit the claim to MetLife directly. Most will, especially if they are in-network.
- Provide Your Insurance Information: Make sure your dentist has your correct MetLife policy number and group number (if applicable). This is essential for them to submit the claim accurately.
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| How To Submit A Claim Metlife Dental |
Step 2: Gather Necessary Information for Your Claim
If your dentist doesn't submit the claim for you, or if you've visited an out-of-network provider, you'll need to gather the required information yourself. Accuracy is key here!
QuickTip: Read again with fresh eyes.
Sub-heading: Essential Documents and Details
- MetLife Dental Expense Claim Form: This is the primary form you'll need. You can usually download it from the MetLife website's forms library or your employer's benefits portal.
- Tip: PrintFriendly.com is mentioned as a resource to fill out and edit the MetLife Dental Expense Claim Form online before printing or saving.
- Patient Information:
- Full Name
- Date of Birth
- Relationship to Subscriber (if you're claiming for a dependent)
- Subscriber Information (the policyholder):
- Full Name
- Policy Number
- Group Number (if applicable)
- Mailing Address
- Phone Number
- Dental Provider Information:
- Dentist's Name
- Dentist's Address
- Dentist's Phone Number
- Provider Tax ID Number (often found on the invoice)
- Service Details:
- Date(s) of Service: The exact dates when the dental procedures were performed.
- Procedure Codes (CDT codes): These are standard codes that describe the dental services received (e.g., D0120 for a periodic oral evaluation, D1110 for adult prophylaxis). Your dentist's office can provide these.
- Tooth Number/Area: Specify which tooth or area of the mouth the procedure was performed on.
- Billed Amount: The total cost charged by the dentist for each procedure.
- Itemized Bill/Invoice: This is critical supporting documentation from your dental office. It should clearly list:
- The services performed
- The date of service for each procedure
- The CDT codes for each procedure
- The cost for each procedure
- The dentist's name and address
- The patient's name
- Payment Authorization: Ensure you authorize MetLife to pay the provider directly (if applicable) or to reimburse you. You'll typically find a section for this on the claim form.
- Signatures: Both the subscriber and, in some cases, the attending dentist will need to sign the form.
Step 3: Complete the MetLife Dental Expense Claim Form
Filling out the claim form correctly is paramount to avoid delays. Take your time and be meticulous.
Sub-heading: Section-by-Section Guidance
- Subscriber Information: Fill in your personal details as the primary policyholder. This includes your name, address, MetLife policy number, and group number.
- Patient Information: If the patient is different from the subscriber (e.g., your child or spouse), provide their details, including their relationship to you.
- Dental Program Information: This section might ask for details about your specific dental plan, but often, just your policy and group number are sufficient.
- Dental Services Received: This is where you detail the procedures. Refer to your itemized bill from the dentist.
- List each procedure with its corresponding date, tooth number (if applicable), CDT code, and the billed amount.
- Double-check that the codes and amounts match your dentist's invoice exactly.
- Attending Dentist Information: Provide the dentist's name, address, and phone number. Some forms may require their Tax ID.
- Payment Authorization: Indicate whether you want MetLife to pay your dentist directly or if you want to be reimbursed. If you're out-of-network and have paid the dentist in full, you'll likely choose direct reimbursement to yourself.
- Signature and Date: Sign and date the form. Some forms may also require the dentist's signature if they are providing specific details or certifications.
Sub-heading: Tips for Accuracy
- Use clear, legible handwriting if filling out a physical form.
- Keep copies of everything you submit, including the completed form and all supporting documents.
- Review your policy for any specific instructions or requirements before completing the form.
Step 4: Submit Your Claim to MetLife
Once your form is perfectly filled out and all supporting documents are ready, it's time to send it to MetLife. You have several convenient options.
Sub-heading: Submission Methods
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Online (MyBenefits Portal/MetLife Mobile App): This is often the fastest and most recommended method if available for your plan.
- Access MyBenefits: Register or log in to your MetLife MyBenefits account (mybenefits.metlife.com).
- Navigate to Claims: Look for a "Claims" or "Submit a Claim" section.
- Follow Prompts: You'll typically be guided through a series of questions.
- Upload Documents: Scan your completed claim form and the itemized bill/invoice from your dentist. You'll upload these as attachments.
- Benefit: Immediate confirmation of submission and often quicker processing.
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Mail: This is a reliable traditional method.
- Address: Send your completed claim form and original itemized bill to: MetLife Dental Claims P.O. Box 981282 El Paso, TX 79998-1282
- Important: Make sure you keep copies of all documents for your records before mailing.
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Fax: For quicker processing than mail, faxing is an option.
- Fax Number: 1-859-389-6505
- Note: Keep the fax confirmation as proof of submission.
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Through Your Dentist (for Out-of-Network): Some out-of-network dentists may still offer to submit the claim on your behalf as a courtesy, even if they aren't directly contracted with MetLife. Always ask!
Step 5: Track Your Claim Status
After submitting your claim, the waiting game begins. Fortunately, MetLife provides easy ways to track its progress.
Sub-heading: How to Check Your Claim's Journey
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MyBenefits Portal/MetLife Mobile App:
- Log in to your account.
- Navigate to the "Claim Status" or "Claim History" section.
- You'll be able to see the date of submission, current status (e.g., "Received," "Processing," "Processed"), and often the payment details once finalized.
- This is the most convenient way to stay updated.
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Customer Service:
- You can call MetLife's dental customer service line. The number is typically found on your ID card or on the MetLife website (often 1-800-GET-MET8 or 1-800-438-6388).
- Have your policy number and the patient's information ready.
Sub-heading: Understanding Processing Times
- Claim processing times can vary, but generally, you can expect a response within a few weeks (typically 15-30 days).
- If you've waited longer than the typical processing time and haven't heard anything, it's a good idea to follow up via the online portal or by calling customer service.
- Explanation of Benefits (EOB): Once your claim is processed, MetLife will send you an EOB. This document explains:
- What was covered
- How much MetLife paid
- Any amounts applied to your deductible
- Your out-of-pocket responsibility
- Any reasons for denial or partial payment
Step 6: Address Any Issues or Denials
Occasionally, claims might be denied or partially paid. Don't panic! There are steps you can take.
QuickTip: Scan the start and end of paragraphs.
Sub-heading: Common Reasons for Denials
- Incomplete Information: Missing fields on the form, incorrect policy numbers, or missing supporting documents.
- Late Submission: Submitting the claim past the allowed timeframe (check your policy for submission deadlines).
- Not a Covered Service: The procedure isn't covered by your plan.
- Waiting Period: The service was performed during a waiting period for new benefits.
- Exceeded Annual Maximum: You've reached your plan's annual limit for benefits.
- Pre-Existing Condition: The policy may have exclusions for certain pre-existing conditions.
Sub-heading: What to Do if Your Claim is Denied
- Review the EOB Carefully: The EOB will state the reason for the denial. Understand why MetLife denied the claim.
- Contact Your Dentist's Office: If the denial seems to be due to incorrect coding or missing information from their end, they can often resubmit or provide additional details.
- Gather More Information: If the issue is unclear, call MetLife customer service to get a detailed explanation.
- Appeal the Decision: If you believe the denial is incorrect, you have the right to appeal. The EOB will usually provide instructions on how to initiate an appeal. This often involves writing a letter explaining why you believe the claim should be covered and providing any additional supporting documentation.
Frequently Asked Questions (FAQs)
Here are 10 related FAQs to help you navigate your MetLife dental claims:
How to find my MetLife dental policy number?
Your MetLife dental policy number can typically be found on your MetLife dental ID card, on your Explanation of Benefits (EOB) statements, or by logging into your MyBenefits account on the MetLife website. If you're still unable to find it, contact your employer's HR or benefits department.
How to get a MetLife dental claim form?
You can usually download the MetLife Dental Expense Claim Form from the "Forms Library" section of the official MetLife website (
How to submit a MetLife dental claim online?
To submit a MetLife dental claim online, log in to your MyBenefits account (mybenefits.metlife.com) or use the MetLife Mobile App. Navigate to the "Claims" section, select "Submit a Claim," fill out the required information, and upload scanned copies of your itemized dental bill and the completed claim form.
QuickTip: Keep a notepad handy.
How to check the status of my MetLife dental claim?
You can check the status of your MetLife dental claim by logging into your MyBenefits account on the MetLife website or through the MetLife Mobile App. Look for a "Claim Status" or "Claim History" section. You can also call MetLife's dental customer service at 1-800-GET-MET8 (1-800-438-6388).
How to understand my MetLife dental Explanation of Benefits (EOB)?
Your MetLife dental EOB is a document that details how your claim was processed. It will show the services billed, the amount your dentist charged, the amount your plan covered, the amount applied to your deductible, any co-insurance, and your remaining patient responsibility. It also explains any denials.
How to ensure my MetLife dental claim is processed quickly?
To ensure quick processing, make sure all sections of the claim form are completely and accurately filled out, attach a clear and detailed itemized bill from your dentist, and submit it online through MyBenefits if possible. Double-check all policy and group numbers.
How to appeal a denied MetLife dental claim?
If your MetLife dental claim is denied, carefully review the Explanation of Benefits (EOB) for the reason. If you believe it's an error, gather any additional supporting documentation (e.g., dentist's notes, X-rays) and write a formal appeal letter explaining why the claim should be covered. Follow the appeal instructions provided on your EOB or the MetLife website.
QuickTip: Skip distractions — focus on the words.
How to find an in-network MetLife dental provider?
You can find an in-network MetLife dental provider by visiting the "Find a Dentist" tool on the MetLife website (metlife.com) or through your MyBenefits account. You can search by your plan type, location, and dentist's name.
How to get reimbursed directly by MetLife for dental services?
If you pay your out-of-network dentist directly, you can request reimbursement from MetLife by marking the "pay subscriber" or "pay enrollee" option on the claim form. Ensure your bank details are updated with MetLife for direct deposit if you prefer that method.
How to contact MetLife dental customer service?
You can contact MetLife dental customer service by calling 1-800-GET-MET8 (1-800-438-6388). Their customer service representatives can assist with eligibility, plan design information, claim status, and general inquiries. You can also find contact information on their website (
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