Orthodontia

2020 Plan Year Information

MetLife Option AMetLife Option BDelta Dental
Note

The figures in the chart below reflect what the Plan pays, with the exception of deductibles and out-of-pocket maximums.

Orthodontics

2019
In-Network:
50% of discounted fee, up to a $3,000 lifetime benefit maximum per person (children to age 19 and adults)

Out-of-Network:
50% of R&C, up to a $3,000 lifetime benefit maximum per person (children to age 19 and adults)

2020
In-Network:
50% of discounted fee, up to a $3,000 lifetime benefit maximum per person (children to age 26 and adults)

Out-of-Network:
50% of R&C, up to a $3,000 lifetime benefit maximum per person (children to age 26 and adults)

2019 & 2020
In-Network:
50% of discounted fee, up to a $2,000 lifetime benefit maximum per child (children only to age 19)

Out-of-Network:
Not covered

2019 & 2020
In-Network:
50% of discounted fee, up to a $3,000 lifetime benefit maximum per person (children to age 26 and adults)

Out-of-Network:
50% of R&C or Allowed Amount (Delta Premier), up to a $3,000 lifetime benefit maximum per person (children to age 26 and adults)

Orthodontics Lifetime Maximum Benefit

The orthodontics lifetime benefit maximum is combined across plan options.