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The claims department reduced the benefit under the alternative benefit clause. The problem is no dentist that practices in the 21st century uses metal for bridges. Zirconia is less expensive and stronger. MetLife saved themselves $160.00. Any company providing a dental plan that actually cares about their employees dental health should consider a different provider.
Typical story- insurance company tries to downgrade benefits under the "alternate benefit" clause when the downgraded benefits are not medically suitable in my specific situation. But every insurance pulls that stuff, what makes MetLife particularly terrible is:
- ridiculous phone tree that doesn't get you where you need, almost never provides a person, and sometimes takes you to a just plain wrong place
- rude and unhelpful customer service people when you reach them
- typical appeals process where no one actually reads/responds to your specific situation
As evidence of the colossally bad customer service, I actually spoke to a "customer service rep" who said that the decision on my case was BENEFEDS policy, and transferred me to BENEFEDS to discuss it. WHAT?? BENEFEDS does not set MetLife's claims policies, I knew it was absurd, but I let her transfer me so they could transfer me back and I could talk to someone else. But a customer service rep who purposely transfers you outside the company to a 3rd party she knows cannot help you? Rude. Terrible. Cannot wait for next open season. This was my VERY FIRST claim with MetLife, and I'm already chomping at the bit to be able to dump them.
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I have Metlife through Benefed which is tied to Fed Government that docks my pay for premiums each mo. When my dentist submits claim for dental work Met Life pays what they term alternate benefit which is less than the fee they negotiated with the Dentist. Then they require me to pay my agreed to percentage and also the amount they did not pay. For some procedures, (i.e.) crowns they should pay 35% of cost but pay less under what they call an alternate benefit. Then they require me to pay my percentage 65% and also the part of their percentage they did not pay. Forget this company.
I am a dental professional, we can never get through to speak to someone. The automated system and options is the worst I have ever experienced. It gives you the runaround and will ultimately ask you to gather your information and disconnect. Today, I finally got to an option that said something like, "Do you want to speak with customer service for eligibility and benefits or speak to customer service about something else?" I said: "Something else." Then it went to options about eligibility and benefits asking for an ID number and told me to "Call back after I gather my information."
HELLO METLIFE!!?- Maybe we're calling to get that information, what if we have a wrong subscriber ID? I've entered the wrong ID and asked to speak with someone and it will not transfer to customer service. Makes you want to drop MetLife so you don't have to deal with them anymore. Our problem is they keep sending requests for additional claim info about our provider (who has been credentialed for a long time) and Metlife is not proactive about helping us fix this problem, cant even speak to someone. Metlife needs to fix their automated system and allow for us to reach a live person more easily.
Good luck trying to get in contact with an actual human-being from this company. Claims are denied repeatedly, when it's very obvious that they are covered. I have tried for hours upon hours to get in touch with someone, and I waste my time going through automated recordings for an eternity, eventually getting disconnected. I have wasted thousands upon thousands of dollars on a company that won't cover simple fillings. This company needs to be investigated. Take a look at their website; try to find a contact number or email. Try calling it. You will see what I'm talking about. Please go elsewhere.
Metlife did not cover dental cleaning. If I have this much trouble with a basic service, fortunately, I will never use or recommend them to anyone. Filing a complaint with the State of FL. Repeated calls have not resolved this incredulous issue. I believe the term is "Elder Abuse". I call it theft.
Sent a complaint in for bad treatment from a dentist in their program and I am still waiting to hear back. They mailed me the paperwork. Now I can't get any answers. I have been waiting over a month. Why is it taking so long? It was sent to the Dental Grievance Department.
I signed up for this plan over a year ago and have been paying premiums every month. Used it once for a routine dental visit for cleaning and evaluation, then again a few months later to address a needed crown that the dentist recommended. That was in 2019. The major problem then was a poorly functioning website that was almost always inaccessible and no real customer service to correct it. Then the pandemic. I received an email telling me I would receive a credit of 25% for two months premiums in April and May. Didn't happen. My provider all but shut down his practice. Couldn't change providers because the website never works. Can't change by calling because you get automated systems that fail or cut you off.
If you get through, it's never to the right person/department so you get transferred and then cut off or lost in a loop. I finally had it and tried to cancel policy. Was bounced around to six different people and cut off by an automated system once before finally getting someone in the billing department. This dental insurance seems like a shell game to me and I would recommend anyone considering MetLife for this type of policy to STOP and go to some other insurer. In fact, their lack of customer service leads me to believe that they do not really want to service what they sell. If they did, there would be a single point to call and a single point to log on, and both would work!
I've been trying to get a claim approved for 3 months now. I confirmed detailed coverage prior to having the treatment. While I am assured every time I call that my procedure is covered the hoops I have to jump through in order to get the money paid out is absurd. I'm not giving up but I have never had to fight so hard. They hope I go away so they don't have to pay me but good luck with that.
MetLife dental is currently trying to deny my wife's claim to a simple (and allowed by policy) dental cleaning. Unbelievable. It took me over 20 minutes to finally get through to a human being on the phone to try to determine why. Well, somewhat human. Rude and ignorant would be more accurate. My company has decided to lock in a 5 year contract with these clowns, but not me. Having priced easily available coverage non-group coverage from Delta Dental my wife and I will be electing to NOT renew group coverage from MetLife in November.
Metlife Dental Insurance author review by Cyril Tuohy
MetLife is one of the largest global providers of insurance products, employee benefit programs and annuities. Based in New York, the company provides dental coverage to over 20 million people.
A global brand: MetLife is one of the most recognized and long-lasting names in the insurance industry.
Great employee plans: MetLife is focused on providing group dental insurance to companies with thousands of employees in the U.S. or abroad.
TRICARE Dental Program: MetLife manages this program for members of active duty uniformed personnel and members of the National Guard, the U.S. Army Reserves and their families.
FEDVIP: MetLife manages the federal employees dental and vision insurance program.
Plenty of information: To keep clients informed, MetLife offers educational resources like the MetLife Oral Health Library on its website.
Metlife Dental Insurance Company Information
- Company Name:
- Metlife Dental Insurance
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