Student Dental Insurance

Metlife Exclusions and Disclaimers

Like most group benefits programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force.  You may be financially responsible for copayments, deductibles, or any other amounts in excess of those MetLife is required to pay for covered services as described in your dental certificate and/or policy.  Ask your MetLife representative for costs and complete details.

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Dental PDP Plan Exclusions

  1. services which are not Dentally Necessary, or those which do not meet generally accepted standards of care for treating the particular dental condition;
  2. services for which You would not be required to pay in the absence of Dental Insurance;
  3. services or supplies received by You or Your Dependent before the Dental Insurance starts for that person;
  4. services which are neither performed nor prescribed by a Dentist, except for those services of a licensed Dental Hygienist which are supervised and billed by a Dentist, and which are for:
    • scaling and polishing of teeth; or
    • fluoride treatments;
  5. services which are primarily cosmetic;
  6. services or appliances which restore or alter occlusion or vertical dimension;
  7. restoration of tooth structure damaged by attrition, abrasion or erosion, unless caused by disease;
  8. restorations or appliances used for the purpose of periodontal splinting;
  9. counseling or instruction about oral hygiene, plaque control, nutrition and tobacco;
  10. personal supplies or devices including, but not limited to: water piks, toothbrushes, or dental floss;
  11. decoration or inscription of any tooth, device, appliance, crown or other dental work;
  12. missed appointments;
  13. services:
    • covered under any workers’ compensation or occupational disease law;
    • covered under any employer liability law;
    • for which the Employer of the person receiving such services is required to pay; or
    • received at a facility maintained by the Policyholder, labor union, mutual benefit association, or VA hospital;
  14. services covered under other coverage provided by the Policyholder;
  15. biopsies of hard or soft oral tissue;
  16. temporary or provisional restorations;
  17. temporary or provisional appliances;
  18. prescription drugs;
  19. services for which the submitted documentation indicates a poor prognosis;
  20. the following, when charged by the Dentist on a separate basis:
    • claim form completion;
    • infection control, such as gloves, masks, and sterilization of supplies; or
    • local anesthesia, non-intravenous conscious sedation or analgesia, such as nitrous oxide;
  21. dental services arising out of accidental injury to the teeth and supporting structures, except for injuries to the teeth due to chewing or biting of food;
  22. caries susceptibility tests;
  23. implant supported Cast Restorations;
  24. initial installation or replacement of Dentures;
  25. modification of removable prosthodontic and other removable prosthetic services;
  26. implants including, but not limited to any related surgery, placement, maintenance, and removal;
  27. implant supported Dentures;
  28. repair of implants;

Contact Us

The enrollment process is administered by Benefit Partners Technology. Call or email our dedicated Student Support Team with questions.            You can reach us toll-free Monday through Friday.

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