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InformationWeek Elite 100: Celebrating ... You pay coinsurance for many covered services and your share is based on the "maximum allowable charge" (MAC) for a given service. MAC is the lesser of the amount charged by the dentist or the maximum payment amount that in-network dentists have agreed to accept in full for the dental service. When you receive dental services from an out-of-network provider, MetLife will reimburse a percentage of the MAC. You are then responsible for paying everything over the percentage of MAC reimbursed up to the charge submitted by the out-of-network dentist. Out-of-network providers typically charge more than the allowable charge, resulting in higher costs for you.
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Acuity White dental filling (one surface, anterior): $149 PPO: Preferred provider organization plans have groups of practitioners who agree to reduced fees for patients within the network. Your costs are lower with network dentists. You may see out-of-network dentists, but it’ll cost you more.
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