MetLife VADIP Frequently Asked Questions

Get answers to your questions about the MetLife VA Dental Insurance Program.

Plan Benefits section<\/a> of this website for details.<\/p>\r\n"}],"ariaLabel":"Benefits"}, {"expandFlag":false,"catName":"Enrollment<\/p>\r\n","qaSet":[{"ariaLabelQuestion":"How does the Veteran Affairs Dental Insurance Program (VADIP) work?","question":"How does the Veteran Affairs Dental Insurance Program (VADIP) work?<\/p>\r\n","answer":"Once you enroll in the VADIP dental program offered by MetLife, you and your eligible dependents must remain in the plan for a period of 12 months (12-month lock-in). If for any reason you decide not to continue with the plan, you can cancel your coverage within the first 30 calendar days of your enrollment (if no claims have been incurred during that time).<\/p>\r\nWhen the 12-month mandatory enrollment period has been completed, and you wish to continue to be covered, you do not have to take any action. If you do not wish to continue with VADIP, you must contact MetLife to request cancellation. You can also contact MetLife to make changes to your coverage after satisfying the 12-month lock-in. If you change your address or move, please make sure to contact MetLife to let us know what your new address is, so that important correspondence reaches you in a timely fashion.<\/p>\r\nWith the MetLife VADIP you receive a wide range of benefits whether you and/or each eligible dependent visit an in-network dentist or choose to see an out-of-network dentist. MetLife\u2019s dental network is one of the nation\u2019s largest with over 458,000 dentist locations. In addition, referrals are not necessary for specialty care. When you visit an in-network dentist, you have the opportunity to make the most of your benefit plan because your out-of-pocket expenses may be lower.<\/p>\r\nThe rates quoted at the time of enrollment are valid until the end of the calendar year, unless otherwise specified.<\/p>\r\nPremium payments can be made via an Electronic Funds Transfer (EFT), or through paper bill.<\/p>\r\n"},{"ariaLabelQuestion":"How do I enroll?","question":"How do I enroll?<\/p>\r\n","answer":"You may enroll in the VADIP using the below options:<\/p>\r\nOnline: visit <a href=https://www.metlife.com/"http://mybenefits.metlife.com/154895/" target=\"_blank\">MyBenefits<\/a><\/p>\r\nBy Phone: call 1-888-310-1681 TDD 888-638-4863 8:00am EST to 11:00pm EST<\/p>\r\nBy Mail: Please <a href=https://www.metlife.com/"/content/dam/metlifecom/us/homepage/vadip/pdf/VADIP_Enrollment_Form.pdf/" target=\"_blank\">download<\/a>, and print the enrollment form<\/p>\r\n"},{"ariaLabelQuestion":"Do I need an ID Card?","question":"Do I need an ID Card?<\/p>\r\n","answer":"No, you do not need to present an ID card to prove coverage or confirm that you are eligible for the VADIP Plan. To access your online ID card, sign into <a href=https://www.metlife.com/"http://mybenefits.metlife.com/154895/" target=\"_blank\">MyBenefits<\/a> and select "Get ID card" from the right navigation bar.<\/p>\r\n"},{"ariaLabelQuestion":"What do I need to do if I want to add a family member to my coverage?","question":"What do I need to do if I want to add a family member to my coverage?<\/p>\r\n","answer":"If your dependents are eligible for VADIP coverage under CHAMPVA, they can enroll in the VADIP, even if the Veteran does not.<\/p>\r\nIf you are a non-CHAMPVA Dependent:<\/p>\r\nWhile non-CHAMPVA dependents are not eligible for the MetLife VADIP, there is a comparable plan you may be able to enroll in. However, you must enroll along with an eligible Veteran.<\/p>\r\nIf the eligible Veteran has already completed enrollment, he or she must contact us at the number below to add you to his or her plan.<\/p>\r\nPlease note that unless they meet certain disability requirements, comparable coverage for children of Veterans is available up to the age of 22. Also, after the age of 19, dependents must provide proof that they are students.<\/p>\r\nPlease call us at 1-888-310-1681 TDD 888-638-4863 from 8:00am EST to 11:00pm EST.<\/p>\r\n"},{"ariaLabelQuestion":"Why am I having trouble enrolling online?","question":"Why am I having trouble enrolling online?<\/p>\r\n","answer":"If you are a Veteran:<\/p>\r\n<ul>\r\n<li>You must apply with the VA to be eligible for the VA health care benefits. Please visit <a href=https://www.metlife.com/"https://www.va.gov/healthbenefits//" target=\"_blank\">www.va.gov/healthbenefits<\/a> for more information.<\/li>\r\n<li>If you just enrolled with the VA for health care benefits, it could take up to 10 days to receive your eligibility information.<\/li>\r\n<li>If you are eligible, you may enroll yourself and up to 9 dependents online.<\/li>\r\n<li>If you have more than 9 dependents, please call 1-888-310-1681 to enroll.<\/li>\r\n<\/ul>\r\nIf you are a CHAMPVA Dependent:<\/p>\r\n<ul>\r\n<li>You must apply with the VA to be eligible for the VA health care benefits. Please visit <a href=https://www.metlife.com/"https://www.va.gov/healthbenefits//" target=\"_blank\">www.va.gov/healthbenefits<\/a> for more information.<\/li>\r\n<li>If you just enrolled with the VA for health care benefits, it could take up to 10 days to receive your eligibility information.<\/li>\r\n<li>You must be at least 18 years or older to self-enroll. If you are under 18, a parent or legal guardian must complete the enrollment process for you.<\/li>\r\n<li>Please note that unless they meet certain disability requirements, CHAMPVA dependents are eligible for coverage up to the age of 19 or up to the age of 23 if a full-time student.<\/li>\r\n<\/ul>\r\nIf you are a non-CHAMPVA Dependent:<\/p>\r\n<ul>\r\n<li>While non-CHAMPVA dependents are not eligible for the MetLife VADIP, there is a comparable plan you may be able to enroll in. However, you must enroll along with an eligible Veteran.<\/li>\r\n<li>If the eligible Veteran has already completed enrollment, he or she must contact us at the number below to add you to his or her plan.<\/li>\r\n<li>Please note that unless they meet certain disability requirements, comparable coverage for children of Veterans is available up to the age of 22. Also, after the age of 19, dependents must provide proof that they are students.<\/li>\r\n<\/ul>\r\nIf you are a non-dependent caregivers/family members:<\/p>\r\n<ul>\r\n<li>If you would like to enroll a Veteran or a dependent, you may register with your information. After registration, you will be asked to provide the beneficiary's information to confirm eligibility.<\/li>\r\n<\/ul>\r\nPlease note that once you complete the enrollment process online, to cancel or make changes to coverage you must contact us at the information below.<\/p>\r\nContact MetLife VADIP: \r\n1-888-310-1681 \r\nTDD: 888-638-4863 \r\nMonday - Friday 8am-11pm EST<\/p>\r\n"},{"ariaLabelQuestion":"What happens when my dependent child, ages out, but they are a full-time student?","question":"What happens when my dependent child, ages out, but they are a full-time student?<\/p>\r\n","answer":"A child loses eligible status when they turn 18, unless enrolled in an accredited school as a full-time student.<\/p>\r\nTo establish student status, and retain CHAMPVA eligibility, an unmarried child between the ages of 18 and 23 must attend school full time. Schools include, but are not limited to, high school, vocational/technical schools, and undergraduate, graduate or postgraduate levels of study. The student can remain eligible for CHAMPVA until the date of graduation or until his or her 23rd birthday, whichever comes first.<\/p>\r\nCHAMPVA will send a letter to the student 90 days prior to his or her 18th birthday that provides notification of the potential change in CHAMPVA eligibility. This letter will also outline the steps necessary to extend CHAMPVA eligibility:<\/p>\r\nTo avoid an interruption of CHAMPVA benefits for the summer break between high school and the first term of the continuing education program, the student must send us proof of intent to continue his or her education (e.g., a letter of acceptance from the educational institution). Once we receive that letter, we will cover the break between high school and the start of the first term of the continuing full-time education program.<\/p>\r\nWithin one month after the first term begins, the student must submit a school certification verifying full-time enrollment. If CHAMPVA does not receive verification, benefits will be terminated, and any payments made by CHAMPVA after the student turned 18 will be subject to recoupment. The certification letter should be on school letterhead and include:<\/p>\r\n<ul>\r\n<li>Student\u2019s full name,<\/li>\r\n<li>Student\u2019s Social Security number,<\/li>\r\n<li>Exact beginning date and ending date of school term (month, date, year),<\/li>\r\n<li>Projected graduation date (month, year),<\/li>\r\n<li>Number of semester hours or equivalent certification of full-time status and<\/li>\r\n<li>Title and signature of a school official. <\/li>\r\n<\/ul>\r\n"},{"ariaLabelQuestion":"Can my non-CHAMPVA eligible dependents, enroll in VADIP?","question":"Can my non-CHAMPVA eligible dependents, enroll in VADIP?<\/p>\r\n","answer":"Dependents of Veterans, except those eligible under CHAMPVA, are not authorized to enroll in VADIP. Dependents may be eligible for separate coverage offered by MetLife that is not affiliated with VADIP or endorsed by the VA. Contact our Customer Service Representative for additional information.<\/p>\r\n"},{"ariaLabelQuestion":"How can I make premium payments?","question":"How can I make premium payments?<\/p>\r\n","answer":"Premium payments can be made either via Electronic Funds Transfer (EFT), where the money is drawn directly from your account, or you can receive paper bills, where payments need to be sent via check.<\/p>\r\nYou can also submit an EFT request form via mail. Please click on the following link to download and print the EFT Form:<\/p>\r\n<a href=https://www.metlife.com/"https://eforms.metlife.com/wcm8/PDFFiles/49338.pdf/" target=\"_blank\">https://eforms.metlife.com/wcm8/PDFFiles/49338.pdf<\/a>. Please follow the submission instructions on the form.<\/p>\r\n"},{"ariaLabelQuestion":"How do I change/view my premium billing information?","question":"How do I change/view my premium billing information?<\/p>\r\n","answer":"To request premium/billing changes please call MetLife at 1-888-310-1681 Monday - Friday 8am-11pm EST.<\/p>\r\n"}],"ariaLabel":"Enrollment"}, {"expandFlag":false,"catName":"Plan Information<\/p>\r\n","qaSet":[{"ariaLabelQuestion":"Do you offer Orthodontia, and who can enroll?","question":"Do you offer Orthodontia, and who can enroll?<\/p>\r\n","answer":"Yes, MetLife's VADIP High Plan offers Orthodontia to children under the age of 19. Please note that there is 24 month waiting period for Orthodontia services.<\/p>\r\n"},{"ariaLabelQuestion":"How does the Veteran Affairs Dental Insurance Program (VADIP) work?","question":"How does the Veteran Affairs Dental Insurance Program (VADIP) work?<\/p>\r\n","answer":"Once you enroll in the VADIP dental program offered by MetLife, you and your eligible dependents must remain in the plan for a period of 12 months (12-month lock-in). If for any reason you decide not to continue with the plan, you can cancel your coverage within the first 30 calendar days of your enrollment (if no claims have been incurred during that time).<\/p>\r\nWhen the 12-month mandatory enrollment period has been completed, and you wish to continue to be covered, you do not have to take any action. If you do not wish to continue with VADIP, you must contact MetLife to request cancellation. You can also contact MetLife to make changes to your coverage after satisfying the 12-month lock-in. If you change your address or move, please make sure to contact MetLife to let us know what your new address is, so that important correspondence reaches you in a timely fashion.<\/p>\r\nWith the MetLife VADIP you receive a wide range of benefits whether you and/or each eligible dependent visit an in-network dentist or choose to see an out-of-network dentist. MetLife\u2019s dental network is one of the nation\u2019s largest with over 500,000 dentist locations. In addition, referrals are not necessary for specialty care. When you visit an in-network dentist, you have the opportunity to make the most of your benefit plan because your out-of-pocket expenses may be lower.<\/p>\r\nThe rates quoted at the time of enrollment are valid until the end of the calendar year, unless otherwise specified.<\/p>\r\nPremium payments can be made via an Electronic Funds Transfer (EFT), or through paper bill.<\/p>\r\n"},{"ariaLabelQuestion":"Do my dependents have to visit the same dentist that I select?","question":"Do my dependents have to visit the same dentist that I select?<\/p>\r\n","answer":"No. You and your dependents each have the freedom to choose any dentist, in or out-of-network, at any time.<\/p>\r\n"},{"ariaLabelQuestion":"What services are covered by the VADIP Plan?","question":"What services are covered by the VADIP Plan?<\/p>\r\n","answer":"The services covered by the VADIP Plan are those set forth under your group dental benefits plan located in the <a href=https://www.metlife.com/"https://www.metlife.com/vadip/plan-benefits//" target=\"_self\">Plan Benefits<\/a> section of this site.<\/p>\r\n"},{"ariaLabelQuestion":"How can I get an estimate of my Out of Pocket expenses?","question":"How can I get an estimate of my Out of Pocket expenses?<\/p>\r\n","answer":"MetLife recommends that you have your dentist submit a request for a pretreatment estimate for services in excess of $300. This often applies to services such as crowns, bridges, inlays, and periodontics. A pretreatment estimate of what services your plan will pay and at what payment level will be sent to you and your dentist. In addition, you can use the Procedure Fee Tool within <a href=https://www.metlife.com/"http://mybenefits.metlife.com/154895/" target=\"_blank\">MyBenefits<\/a> to view MetLife in-network procedure costs and estimated out-of-network procedure costs in a zip code area. Once you register, the Procedure Fee Tool is available within the Quick Links on the right-hand side of the page or from the Tools and Resources tab.<\/p>\r\n"},{"ariaLabelQuestion":"What is the effective date of my coverage?","question":"What is the effective date of my coverage?<\/p>\r\n","answer":"If you enroll on or before the 15th of the month, your coverage will be effective on the first day of the month following the month of your enrollment.<\/p>\r\nIf you enroll after the 15th of the month, your coverage will be effective on the first day of the second following month.<\/p>\r\nFor example: an enrollment completed on June 9th would have a July 1st effective date, but an enrollment completed on June 17th would have an August 1 effective date.<\/p>\r\n"},{"ariaLabelQuestion":"What is a Graduated Maximum?","question":"What is a Graduated Maximum?<\/p>\r\n","answer":"A Graduated Maximum is a feature of the plan that encourages participation in the plan by increasing your Annual Maximum by $500 (in the high plan option) or $200 (in the standard plan option), effective on January 1st, following the completion of 12 months of enrollment in your selected plan.<\/p>\r\n"},{"ariaLabelQuestion":"May I choose an out of network dentist?","question":"May I choose an out of network dentist?<\/p>\r\n","answer":"Yes. You are always free to select the dentist of your choice. However, if you choose a dentist who does not participate in MetLife\u2019s Network, your out-of-pocket expenses may be higher.<\/p>\r\n"}],"ariaLabel":"Plan Information"}, {"expandFlag":false,"catName":"Provider<\/p>\r\n","qaSet":[{"ariaLabelQuestion":"What is an in-network dentist and how do I find one?","question":"What is an in-network dentist and how do I find one?<\/p>\r\n","answer":"An in-network dentist is a general dentist or specialist who participates in MetLife\u2019s PDP Plus Network and has agreed to accept a negotiated fee for services rendered to eligible Veterans. This negotiated fee is typically 30% to 45% below the average fee charged by dentists for the same services in a given geographical area. Over 85% of U.S. dental offices participate in the MetLife PDP Plus Network.<\/p>\r\nAccess a list of MetLife\u2019s <a href=https://www.metlife.com/"https://providers.online.metlife.com/findDentist?searchType=findDentistVA&planType=DPPO&networkID=2\%22 target=\"_self\">in-network dentists now<\/a><\/p>\r\nContinued participation of any specific provider cannot be guaranteed. Thus, you may wish to make coverage decisions based on the plan benefits, not based on a specific provider. When you call for an appointment, please remember to verify that the selected provider is currently in the MetLife PDP Plus Network.<\/p>\r\n"},{"ariaLabelQuestion":"What if my dentist is not in the network?","question":"What if my dentist is not in the network?<\/p>\r\n","answer":"We encourage you to consider using a MetLife in-network dentist to help maximize the value of your plan. Of course, you can visit any dentist and still receive benefits under your plan although your out-of-pocket expenses may be higher when you visit an out-of-network dentist. If your dentist does not participate in our network, it\u2019s easy to submit a <a href=https://www.metlife.com/"https://mybenefits.metlife.com/getGroupByIdForHP.htm?group=154895&p=ENR&l=23\%22 target=\"_blank\">nomination online<\/a>. Just complete the required information. Once submitted, we will contact that dentist with an invitation to join our dental networks.<\/p>\r\n"},{"ariaLabelQuestion":"Do my dependents have to visit the same dentist that I select?","question":"Do my dependents have to visit the same dentist that I select?<\/p>\r\n","answer":"No. You and your dependents each have the freedom to choose any dentist, in or out-of-network, at any time.<\/p>\r\n"},{"ariaLabelQuestion":"May I choose an out of network dentist?","question":"May I choose an out of network dentist?<\/p>\r\n","answer":"Yes. You are always free to select the dentist of your choice. However, if you choose a dentist who does not participate in MetLife\u2019s network, your out-of-pocket expenses may be higher.<\/p>\r\n"},{"ariaLabelQuestion":"What is a negotiated fee*?","question":"What is a negotiated fee*?<\/p>\r\n","answer":"A negotiated fee refers to the maximum charge for a service that an in-network dentist may charge to VADIP Plan participants. These fees are typically 30% to 45% below the average fee charged by a dentist for the same services in your area. Your plan may reimburse you for all or part of this fee. When you use an in-network dentist, you are responsible only for the difference between your plan's benefits payment amount and the negotiated fee for the services rendered (subject to any deductibles and maximum benefits).<\/p>\r\n* Occasionally, there may be a service for which the dentist's fee is the same or less than the MetLife negotiated fee for that service.<\/p>\r\n"},{"ariaLabelQuestion":"Can an in-network dentist charge me his or her \"usual\" fee when a dental procedure is not covered under my dental plan?","question":"Can an in-network dentist charge me his or her "usual" fee when a dental procedure is not covered under my dental plan?<\/p>\r\n","answer":"An in-network dentist should not bill you for amounts that are in excess of the negotiated fees that your dentist has agreed to accept as payment for services. This rule applies even if services are not covered under your specific dental plan. You should always verify that your dentist is a MetLife in-network dentist at the time of your appointment. To search for an in-network dentist near your job or home (including a map and driving directions), use the <a href=https://www.metlife.com/"https://providers.online.metlife.com/findDentist?searchType=findDentistVA&planType=DPPO&networkID=2\%22 target=\"_self\">Find a Dentist<\/a> function on this site or call a MetLife Customer Service Specialist \u2013 1-888-310-1681/TDD 1-888-638-4863.<\/p>\r\n"},{"ariaLabelQuestion":"Why aren\u2019t there any in-network dentists in my area?","question":"Why aren\u2019t there any in-network dentists in my area?<\/p>\r\n","answer":"Not all dental practices join a dental network. This may be due to their unique circumstances or a philosophical difference.<\/p>\r\n"},{"ariaLabelQuestion":"How do I review my personal claim information?","question":"How do I review my personal claim information?<\/p>\r\n","answer":"Please access/register for the <a href=https://www.metlife.com/"http://mybenefits.metlife.com/154895/" target=\"_blank\">MyBenefits<\/a> site from the home page. MyBenefits allows you to manage your benefits easily. You may view your claim and personal information.<\/p>\r\n"}],"ariaLabel":"Provider"}]" class="microFAQ-categoryDetails" uniquename="faq_microsite" openlabel="Expand All" closelabel="Collapse All">

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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. Please contact MetLife or view the VADIP Plan Summary for cost and complete details.

MetLife strongly recommends that you have your dentist submit a pretreatment estimate to MetLife if the cost is expected to exceed $300. When your dentist suggests treatment, have him or her send a claim form, along with the proposed treatment plans and supporting documentation, to MetLife. An explanation of benefits (EOB) will be sent to you and the dentist detailing an estimate of what services MetLife will cover and at what payment level. Actual payments may vary from the pretreatment estimate depending upon annual maximums, deductibles, plan frequency limits and other plan provisions at time of payment.

The Dental Procedure Fee Tool application is provided by an independent vendor. This tool does not provide the payment information used by MetLife when processing your claims. Prior to receiving services, pretreatment estimates through your dentist will provide the most accurate fee and payment information.

Group dental insurance plans featuring the Preferred Dentist Program are provided by Metropolitan Life Insurance Company, New York, NY.

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.

* Where two or more professionally acceptable dental treatments for a dental condition exist, reimbursement is based on the least costly treatment alternative. If you and your dentist have agreed on a treatment that is more costly than the treatment upon which the plan benefit is based, you will be responsible for any additional payment responsibility. To avoid any misunderstandings, we suggest you discuss treatment options with your dentist before services are rendered and obtain a pretreatment estimate of benefits prior to receiving certain high cost services such as crowns, bridges or dentures. You and your dentist will each receive an Explanation of Benefits (EOB) outlining the services provided, your plan’s reimbursement for those services, and your out-of-pocket expense. Actual payments may vary from the pretreatment estimate depending upon annual maximums, plan frequency limits, deductibles and other limits applicable at time of payment.

MetLife VADIP Frequently Asked Questions

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