[ HEALTH ]
DENTALCOVERAGE YOU CAN SMILE ABOUT
Choose from three dental plans — Basic, Enhanced and a DHMO — each offered by Cigna with a different level of coverage and affordability to meet your needs. Select the boxes below to see details for each option.
Under the Basic and Enhanced plans, you can use any dentist and receive the same level of benefits, whether the dentist is in- or out-of-network. However, your costs will likely be less when you use an in-network dentist because Cigna negotiates better rates with these providers. You are responsible for out-of-network amounts above the Cigna-negotiated rate.
The DHMO is a Dental Health Maintenance Organization, which means you use providers within the DHMO network. Under the DHMO plan, you must designate a Network General Dentist for routine care. Referrals for Specialty Care must be made by your Network General Dentist. The DHMO covers most dental expenses at contracted rates with no deductible or annual limit. See the Cigna Dental Care Plan Patient Charge Schedule for details.
| Benefit | Basic | Enhanced | ||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Preventive (exams, cleanings) | 100% no deductible | 100% no deductible | 100% no deductible | 100% no deductible |
| Restorative (fillings, extractions) | 65% no deductible | 65% no deductible | 80% no deductible | 65% no deductible |
| Major (crowns, bridges, dentures) | 50% no deductible | 50% no deductible | 50% no deductible | 50% no deductible |
| Orthodontia | N/A | 50% no deductible | 50% no deductible | |
| Annual Maximum | $2,000 | $2,000 | ||
| Annual Deductible | $150 Individual $300 Family |
$125 Individual $250 Family |
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Basic Plan
This plan covers:
• Preventive services — periodic exams and cleanings
• Basic restorative procedures — fillings and extractions
• Certain major restorative procedures — inlays, onlays, implants, bridges and dentures
Enhanced Plan
This plan covers:
• Preventive services — periodic exams and cleanings
• Restorative procedures — fillings and extractions
• Major procedures — root canals and crowns
• Orthodontia for covered adults and dependents under age 19
DHMO Plan
This plan covers preventive care, general services, orthodontia, and pediatric care for covered adults and dependents up to age 13, based on a benefit schedule.
