A $1,480 crown, an $830 allowance, and the 2027 codes both plans added
The 2027 federal dental documents are published on the carriers' own sites, and the design barely moved: both plans added the same three codes, Delta filed the denture fix as major work while MetLife filed it as intermediate, and Delta's own price table reveals an in-network crown allowance near $830 against $1,480 for a cash patient.
The 2027 dental plan documents are published. Finding them takes a detour. OPM's dental plan page still lists 2026 brochures for all eleven carriers, and the 2027 brochure address on the same page returns an error 1. Both carriers now post their own 2027 files: MetLife's federal dental page now opens on "2027 Plan Details," last updated Oct. 14 2, and Delta Dental publishes a 2027 brochure and a 2027 highlights sheet on its member site 34.
Open season runs Nov. 9 to Dec. 14, and whatever gets chosen this year holds for all of 2027 5.
The 2027 design comes out almost identical to 2026 on both sides. What moved is the list of covered procedure codes, and one of those additions is worth real money to anyone who wears dentures.
What the two plans added
MetLife's brochure carries a page headed "How We Have Changed for 2027" that lists seven new codes 6. Delta's carries four 3.
| New code | What it pays for | MetLife class | Delta class |
|---|---|---|---|
| D5521, D5522 6 | Replacing all the teeth on a complete upper or lower denture | Class B | Class C |
| D6126 3 | Replacing all teeth and acrylic on a hybrid prosthesis, per arch | Class C | Class C |
| D1209 6 | A topical non-fluoride decay-prevention treatment, full mouth | Class A | Not added |
| D5859 6 | A semi-precision abutment on a natural tooth | Class C | Not added |
| D8689 6 | Re-cementing a fixed orthodontic appliance | Class D | Not added |
| D9937 6 | Cleaning and inspection of an occlusal orthotic device | Class C | Not added |
| D9998 4 | Case management for a patient moving from pediatric to adult care | Not added | General services |
Three codes show up on both lists. That overlap suggests D5521, D5522 and D6126 arrived with the annual code-set update rather than from either carrier expanding benefits, and each carrier filed the new codes where its own schedule put them. Delta's list gives no class for D9998 and files the code with its general services.
Those filings differ in a way that costs money. MetLife treats a denture re-tooth as Class B, where a Standard member pays 45% of the allowance and a High member pays 30%. Delta Dental treats the same work as Class C, where the member pays 65% on Standard and 50% on High 36.
What a denture re-tooth now costs
A denture's teeth wear flat over years of chewing, and the fix is a lab job on the existing plate: new teeth set into the same base. Neither carrier publishes what it allows for the procedure, so the national averages on a consumer financing company's published cost list stand in 7. A traditional upper and lower denture set averages $1,968. A basic set runs $452, a premium set $6,514, and an immediate set $2,178.
Re-toothing both plates is lab work billed below a new set, so $1,968 is the ceiling. Against that ceiling:
| A full set of new denture teeth, at the $1,968 average | Member pays |
|---|---|
| MetLife High, 30% 6 | $590.40 |
| MetLife Standard, 45% 6 | $885.60 |
| Delta Dental High, 50% 3 | $984 |
| Delta Dental Standard, 65% 3 | $1,279.20 |
The gap between the two Standard options on identical work is $393.60, and it costs $4.20 a year more to hold the MetLife one 8. A reader with a worn denture and no other expected work can stop the comparison there.
Delta's own site puts the same subject in plainer numbers. It publishes a table of what each plan costs a member against what the same procedures cost with no insurance: a denture at $570 on Standard and $450 on High, against $2,085 uninsured 9. The page labels these national averages for in-network providers and leaves premiums out.
The 2027 grid, four options
Premiums below are 2027 self-only monthly rates for rating region 1 8. Each carrier maps ZIP codes to its own regions, and both brochures print the full maps. Shares are what the member pays; a lower number is better.
| 2027, self-only | Delta Standard | Delta High | MetLife Standard | MetLife High |
|---|---|---|---|---|
| Monthly premium | $23.68 | $39.67 | $24.03 | $40.76 8 |
| Class A in network, out of network | 0%, 40% | 0%, 10% | 0%, 40% | 0%, 10% 36 |
| Class B in network, out of network | 45%, 60% | 30%, 40% | 45%, 60% | 30%, 40% 36 |
| Class C in network, out of network | 65%, 80% | 50%, 60% | 65%, 80% | 50%, 60% 36 |
| In-network deductible | $0 | $0 | $0 | $0 36 |
| Out-of-network deductible | $75 | $50 | $100 | $50 36 |
| Annual maximum, in network | $1,500 | Unlimited | $2,000 | Unlimited 36 |
| Annual maximum, out of network | $1,000 | $3,000 | $2,000 | Unlimited 36 |
| Child orthodontics, lifetime | $2,000 | $3,500 | $1,500 | $3,500 346 |
| Adult orthodontics, lifetime | None | $2,000 | $1,500 | $3,000 346 |
Class A is exams, cleanings and X-rays; Class B is fillings, extractions and periodontal maintenance; Class C is crowns, root canals, dentures and implants. The allowance is the most the plan recognizes for a procedure, and every share above is a percentage of that figure.
Four rows separate the four columns, and each answers a different question. A heavy year of crowns runs into the annual maximum, where MetLife Standard's $2,000 sits $500 above Delta Standard's $1,500 in network and $1,000 above its out-of-network ceiling. An out-of-network year meets the deductible first, where Delta Standard asks $75 and MetLife Standard $100. Orthodontics runs into a lifetime cap on both plans, where Delta Standard's $2,000 for a child beats MetLife's $1,500, while MetLife Standard pays $1,500 toward an adult and Delta Standard pays nothing.
Delta's 2027 highlights sheet carries the same benefit grid as the 2026 sheet, every percentage and every maximum unchanged 4. The 2027 sheet adds one perk, virtual dentistry, which Delta marks as outside the federal program.
Waiting periods are where the two documents differ in clarity. Delta states plainly that there are none, "for any covered services, including orthodontics" 4. MetLife's 2027 brochure carries no waiting-period clause, and its limitations sit inside each service entry instead.
The price behind the list price
Delta's with-and-without table does more than list prices. It lets a reader recover the fee the carrier negotiated, which is the number worth asking about.
Take the crown. Delta says a Standard member pays $540, and the member share on Class C is 65% of the plan allowance. Divide $540 by 0.65 and the allowance lands at $830.77. The High option gives a check: $400 at a 50% share implies an allowance of $800. Two different options, two different shares, allowances $31 apart, which is what a single network fee should look like.
Run the same division on the other two lines. A root canal at $610 on Standard implies $938.46, against $1,510 uninsured. A denture at $570 implies $876.92, against $2,085 uninsured 9.
The crown allowance of roughly $800 to $830 is less than 60% of the $1,480 that Delta's table gives as the uninsured price for the same crown. The national average on the CareCredit list sits between them at $1,399 7.
That gap belongs to the network rather than to the plan, and it runs far wider than the difference between two carriers. A reply in this week's forum thread below put the spread between carriers at 10% to 15% of fees.
So the ask at the front desk has a shape. Request the office's in-network fee for the exact code, request its cash price for the same code, and compare the two. An office inside Delta's or MetLife's network has already agreed to a figure near $830 for a crown; a reader paying cash can use that number as the anchor, with the $1,399 national average as a fallback.
The chronic-condition benefit most members never enroll in
Delta's 2027 highlights sheet carries a benefit that changes the arithmetic on gum treatment. Members with a listed chronic condition can enroll in SmileWay Wellness Benefits through their online account. Enrollment brings 100% coverage of one scaling and root planing procedure per quadrant per calendar year, plus four more periodontal services a year from a menu of cleanings, periodontal maintenance and a full-mouth scaling 4.
The condition list covers diabetes, heart disease, cancer, chronic kidney disease, stroke, lupus, rheumatoid arthritis, HIV and AIDS, Parkinson's disease, ALS, Huntington's disease, opioid misuse, joint replacement and Sjögren's syndrome.
A member who skips the enrollment pays nothing for a cleaning and 45% of the allowance for periodontal maintenance on Standard, capped at four in a calendar year. A reader managing diabetes and gum disease is the intended user of this benefit, and the enrollment has to be made.
What this week's threads show
Four threads ran in the window, and each one lands on a number in this issue.
On Oct. 17 a reader in Tampa described needing three root canals, four crowns and scaling and root planing in all four quadrants, and choosing between Humana, Ameritas and MetLife Standard for open enrollment. The question was which carrier negotiates lower rates with dentists 10. One reply said fee schedules are practice-specific even inside one corporate group, and put the spread between carriers at 10% to 15% 10. Another reply pointed out that a practice can sit in a carrier's network through an umbrella network rather than a direct contract, which is why two plans can quote the same dentist differently.
On Oct. 13 a reader with an uninsured relative needing dentures and two crowns compared two discount plans, Care 500 and Aetna Dental Access, and was surprised that dentists cannot simply offer a cash discount 11. A discount plan sells access to a fee schedule for a membership fee and pays no claims, so the only question that matters before joining is what the plan's fee is for the exact code.
On Oct. 18 a dental office worker asked what the largest bill insurance had left people paying, and the answers ran through crowns, root canals and implants 12. A 65% Class C share on a Standard plan answers that question before the first reply arrives.
Also on Oct. 18 a federal employee posted that their dentist emailed patients "highly encouraging" them to choose GEHA for 2027, with no reason given, from a practice in network with every major carrier 13. A practice can prefer a carrier whose fee schedule suits it, which is a reason to ask the practice which codes and fees drive the preference before following the recommendation.
Vision held flat
MetLife's 2027 vision brochure says outright that 2027 brings no plan changes, and its allowances match 2026 to the dollar 14. On Standard, a featured-brand frame draws $190, a standard-brand frame $150, and a frame bought at Costco, Walmart or Sam's Club $85 with a $20 copay. On High the same three rows pay $250, $200 and $200 with no copay. The eye exam is covered in full once a calendar year on both, elective contact lenses get $120 or $150 instead of glasses, and lens fitting runs up to $55 15.
The numbers a reader may still be carrying from an older year are higher than that, because MetLife cut them going into 2026. Its 2026 brochure records the change: High went from $310 for standard frames, $360 for featured brands and $310 at warehouse clubs down to $200, $250 and $200. Standard went from $210, $250 and $115 down to $150, $190 and $85 16. The 2027 document holds the lower set.
VSP's federal page still advertises $200 toward a featured-brand frame and $150 toward a standard frame on Standard, $250 and $200 on High, with $120 or $150 for contacts instead 17. On a featured-brand frame the two are $10 apart; at a warehouse club the gap widens to $65, because MetLife drops to $85 there and VSP keeps $150. For contacts, they pay the same.
EyeMed, which sells through employers rather than through the federal program, uses the same definition of an allowance: the amount a member can put toward frames, contacts or other purchases, with anything above it paid out of pocket 18. Its member FAQ carried no plan change in this window.
Before Nov. 9
Six questions settle most of the 2027 decision, and each maps to a number above.
- What does my dentist's office charge in its network for the code I need, and what does it charge a cash patient for the same code?
- Is my dentist in the network directly, or through an umbrella network the plan rents access to?
- How much annual maximum do I have left before Dec. 31, and what treatment is already scheduled for the first months of 2027?
- Am I an adult who may want braces or aligners inside the plan year, which rules out Delta Dental Standard and puts MetLife Standard at $1,500 lifetime?
- Do I have any condition on Delta's wellness list, which makes my cleanings and periodontal maintenance free once I enroll?
- What does the same visit cost at a dental school clinic, where fees run below private practice under faculty supervision 19?
References
- 1
- 2Federal Dental Plan Details
fedvip.metlife.com
- 32027 Delta Dental Plan Brochure
www1.deltadentalins.com
- 42027 Delta Dental Plan Highlights
www1.deltadentalins.com
- 5
- 62027 The MetLife Federal Dental Plan
fedvip.metlife.com
- 7Dentist Prices: Dental Procedure Cost List
carecredit.com
- 82027 FEDVIP Dental Premiums
opm.gov
- 9Delta Dental FEDVIP
deltadentalins.com
- 10Humana vs. Ameritas vs. MetLife PPO
reddit.com
- 11Care 500 vs AETNA direct access?
reddit.com
- 12
- 13
- 142027 The MetLife Federal Vision Plan
fedvip.metlife.com
- 15Federal Vision Plan Details
fedvip.metlife.com
- 162026 The MetLife Federal Vision Plan
fedvip.metlife.com
- 17Choose VSP
federal.vsp.com
- 18EyeMed Member FAQs
eyemed.com
- 19Access Lower-Cost Dental Care
penndentalmedicine.org
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