Dental

KISD provides employee three dental plan options to choose from. Select from two PPO plans and one DHMO plan.

When choosing between PPO and DHMO dental plans, consider factors such as your preferred dentist, budget, the level of flexibility you desire, and the overall dental needs of you and your family. Carefully review the details of each plan, including network providers, covered services, copayments, deductibles, and annual maximums, to make an informed decision.

To manage your plan and access a digital id card download MetLife’s mobile app or the MyBenefits Portal.

- Provider Network: DHMO plans have a network of participating dentists who provide dental services at predetermined, fixed rates. You must choose a primary care dentist (PCD) from within the network, and they act as your main point of contact for all dental care needs.
- Copayments: With DHMO plans, you pay fixed copayments for specific services, such as cleanings, exams, fillings, and other treatments. The copayment amounts are predetermined by the plan.
- No Out-of-Network Coverage: DHMO plans typically do not provide coverage for out-of-network dentists. If you choose to see a dentist outside the network, you may be responsible for the full cost of treatment.
- No Deductibles or Maximums: DHMO plans usually do not have deductibles or annual maximums. You can receive dental care without worrying about meeting a deductible, and there are no maximum limits on the coverage provided.
- Referrals and Specialist Visits: If you need to see a specialist under a DHMO plan, you generally require a referral from your primary care dentist. Referrals are needed to ensure the coordination of care within the network.
- Provider Network: PPO plans have a network of preferred dentists and specialists with whom the insurance company has negotiated discounted rates. You have the flexibility to choose any dentist, but visiting in-network providers will result in lower out-of-pocket costs.
- Cost-sharing: PPO plans typically involve cost-sharing arrangements, where you pay a percentage of the dental services provided (coinsurance) while the insurance covers the remaining portion. The cost-sharing varies depending on the type of treatment received.
- Out-of-Network Coverage: PPO plans may provide partial coverage for out-of-network dentists, but the reimbursement rates are usually lower, and you may have higher out-of-pocket expenses.
- Annual Deductibles and Maximums: PPO plans often have an annual deductible that you must meet before the insurance coverage starts. They also typically have an annual maximum, which is the maximum amount the insurance company will pay for dental care within a calendar year.
- Flexibility and Choice: PPO plans offer more flexibility in terms of choosing dentists and specialists. You can see any provider, including those outside the network, and still receive some level of coverage.
- Review the 2023-2024 MetLife Dental PPO Plan Summary for plan details