Dental Plans
SELECT YOUR LOCATION:
Your Plans
Two plans are provided through Cigna and feature a comprehensive network of providers.
Cigna Dental HMO Plan
- Not available in AK, ME, MT, ND, NH, PR, SD, U.S. Virgin Islands, VT, or WY.
- Must choose a primary care dentist from the network
- Typically does not cover out-of-network dental care (there may be exceptions for certain emergency services).
- Most in-network preventive dental care is covered at 100% (cleanings, routine exams, and routine X-rays)
- If you need to see a specialist, your primary care dentist will refer you to a provider within the network.
Cigna Dental PPO Plan
- Choose from a network of providers
- Costs may be higher if your provider is out-of-network
- Has an annual deductible and coinsurance
- Most in-network preventive dental care is covered at 100% (cleanings, routine exams, and routine X-rays)
- You may be required to pay a copay at the time of your visit and share costs with your plan for any care that goes beyond preventive care.
Coverage (You Pay)
IS THERE A LINK TO THE PATIENT CHARGE SCHEDULE?
| Benefit/Covered Service | Cigna Dental HMO Plan (In-network)* | Cigna Dental PPO Plan (In-network) | Cigna Dental PPO Plan (Out-of-network) |
|---|---|---|---|
| Preventive/diagnostic care | Review Patient Charge Schedule | $0 (deductible waived) | Plan covers 100% of R&C (deductible waived) |
| Deductible (Individual) | None | $50 | $50 |
| Deductible (Family) | None | $150 | $150 |
| Calendar year maximum | Unlimited | Plan pays up to $2,000 per person | Plan pays up to $2,000 per person |
| Basic restorative (Oral surgery, endodontics, periodontics, includes amalgam fillings, and crowns) | Review Patient Charge Schedule | $0 for DPPO Advantage network. Plan pays 80% in DPPO network | Plan covers 80% of R&C |
| Major restorative/prosthodontics | Review Patient Charge Schedule | 50% | Plan covers 50% of R&C |
| Orthodontia (Adult and children) | Review Patient Charge Schedule | Plan covers 50%, up to $2,000 (deductible waived) | Plan covers 50%, up to $2,000 (deductible waived) |
| Primary dentist election required | Yes | No | No |
*The Cigna HMO Plan is not available in AK, ME, MT, ND, NH, NM, PR, SD, U.S. Virgin Islands, VT, or WY.
Contributions
Contributions are taken out of your paycheck pre-tax.
Cigna Dental HMO Plan
| How much you pay | Weekly | Bi-weekly |
|---|---|---|
| Employee | $0.00 | $0.00 |
| Employee + Spouse | $0.74 | $1.47 |
| Employee + Child(ren) | $1.14 | $2.28 |
| Family | $2.07 | $4.14 |
Cigna Dental PPO Plan
| How much you pay | Weekly | Bi-weekly |
|---|---|---|
| Employee | $0.00 | $0.00 |
| Employee + Spouse | $3.46 | $6.92 |
| Employee + Child(ren) | $2.99 | $5.97 |
| Family | $6.07 | $12.15 |