The main difference between in-network and out-of-network providers is the amount you will pay a provider for service.  When a provider partners with an insurance company (in-network), the provider agrees to a negotiated rate for services. Negotiated fees refer to the fees that in-network dentists have agreed to accept as payment in full for certain services, subject to any co-payments, deductibles, cost sharing and benefits maximums. Negotiated fees are subject to change. Negotiated fees do not apply to non-covered services in states that prohibit limitations for services not covered under a plan. Participating providers in these states may charge their non-negotiated fees for non-covered services. When a provider does not partner with an insurance company (out-of-network), the provider is able to charge full price for their services. You may see any provider, but you will get the most benefit from your insurance by visiting an in-network provider. If you choose an out-of-network provider, you may have increased expenses, will need to pay in full at the time of services, and will need to file a claim with MetLife for reimbursement.

An annual maximum is the maximum dollar amount a benefit plan will pay toward the cost of care within a specific benefit period.

The portion of the cost of your treatment that you are required to pay. Most plans pay a pre-determined percentage of the cost, and you pay your coinsurance amount even after your deductible is reached.

A specific dollar amount that you must pay before the plan begins to cover your expenses.

This is a document you receive from your insurance carrier after you visit the provider. It is not a bill, but rather an explanation of what procedures were performed and what was covered by your plan. These documents may vary with different insurance providers but should include the provider’s fee, the portion your insurer paid and any amount you may owe (such as deductible, coinsurance or non-covered services). It should also include an update on how much of your annual maximum has been used and the amount you’ve paid toward your deductible.

Your plan is a month-by-month plan and will continue until you contact the carrier to cancel. Please contact the carrier directly for more information.

Benefit Partners Technology administers the enrollment and payment process. If you have any questions, please contact the Student Support Team toll-free at (877) 247-8817. 

For questions about benefits or claims, please visit the Contact Us page of this website for carrier specific contact information.