Cigna Dental 1000

Plans insured by Cigna Health and Life Insurance Company :

Cigna Dental 1000

Starting from $30 per person, per month†

or call us 1-855-352-1604

You know dental care is important. Keep dental expenses down with an affordable plan that covers the preventive dental care you and your family need. This plan can also help you take care of cavities, gum disease, and major dental work. Annual exams, routine x-rays, and cleanings are covered at 100% when you visit a Cigna Dental Preferred Provider Organization (DPPO) Advantage provider.¹

If you had a qualified dental insurance plan in place for at least 12 consecutive months before you joined Cigna, we will waive the waiting periods for restorative care, so you can get that filling or root canal right away. If you’ve been without dental insurance, there is a waiting period of 6 months for basic restorative services and 12 months for major restorative services.²

With this flexible dental PPO plan, you can see any dentist, but you may save money by choosing from our national network of over 90,000 unique dentists at over 286,000 locations.*, **

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Benefits of All Cigna Dental Plans

Convenient billing and payments. Get your medical and dental insurance statements on one bill if you have Cigna for both.
No claims submissions when you visit an in-network dentist. Cigna network dentists submit claims automatically.
No need to choose a primary dentist. And no referrals needed for specialist care.
Access to our national network of over 90,000 unique dentists at over 286,000 locations.* Choose from in-network or out-of-network providers. Stay in-network to get the most benefits.
Where available, access to the Cigna Dental Oral Health Integration Program^® for pregnant women and people with certain health conditions.
Digital tools for members, including the myCigna® mobile app.⁸
24/7/365 live customer service, when and where you need it: 1-800-997-1654

Deductibles and Maximums

Benefit	DPPO Advantage Network	Out-of-network
Individual Calendar Year Deductible	$50 per person (waived for preventive services¹)	$50 per person (waived for preventive services¹)
Family Calendar Year Deductible	$150 per family (waived for preventive services¹)	$150 per family (waived for preventive services¹)
Calendar Year Benefit Maximum	$1,000 per person	$1,000 per person
Separate Lifetime Individual Orthodontia Deductible	Not covered	Not covered

Preventive/Diagnostic Services

Benefit	DPPO Advantage Network	Out-of-network
Preventive/Diagnostic Services Waiting Period	Not applicable	Not applicable
Preventive Diagnostic Services (Oral exams, cleanings, x-rays, fluoride application, sealants, non-orthodontic space maintainers)	You pay 0%	You pay the difference between the provider's standard fee and 100% of the Maximum Allowable Charge (MAC)³

Procedure	Frequency/Limitation⁴
Oral Exams	1 per consecutive 6-month period
Routine Cleanings	1 routine prophylaxis or periodontal maintenance procedure per consecutive 6-month period (routine prophylaxis is Class I; periodontal maintenance procedure is Class III).
Routine X-Rays	Bitewings: 1 set in any consecutive 12-month period. Limited to a maximum of 4 films per set.
Fluoride Treatment	1 per consecutive 12 months for participants less than age 14
Sealants	1 treatment per tooth per lifetime. Payable on unrestored permanent bicuspid or molar teeth for participants less than age 14
Space Maintainers (non-orthodontic)	Limited to non-orthodontic treatment for prematurely removed or missing teeth for a person less than 14 years old

Basic Restorative Services

Benefit	DPPO Advantage Network	Out-of-network
Basic Restorative Services Waiting Period	6-month waiting period²	6-month waiting period²
Basic Restorative Services (Fillings, non-routine x-rays)	You pay 20% of the provider's contracted fee (after deductible)	You pay the difference between the provider's standard fee and 80% of the Maximum Allowable Charge (MAC) after deductible³

Procedure	Frequency/Limitation⁴
Fillings	1 per tooth per 12 consecutive months (applies to replacement of identical surface fillings only). No white/tooth colored fillings on bicuspid or molar teeth
Non-routine X-Rays	Full mouth or Panorex: 1 per 60 consecutive months
Routine Tooth Extraction	Includes an allowance for local anesthesia and routine postoperative care
Emergency Treatment	Paid as a separate benefit only if no other service, except x-rays, is rendered during the visit

Major Restorative Services

Benefit	DPPO Advantage Network	Out-of-network
Major Restorative Services Waiting Period	12-month waiting period²	12-month waiting period²
Major Restorative Services⁵	You pay 50% of the provider's contracted fee (after deductible)	You pay the difference between the provider's standard fee and 50% of the Maximum Allowable Charge (MAC) after deductible³

Procedure	Frequency/Limitation⁴
Periodontal (Deep Cleaning)	1 per quadrant per consecutive 36 month period
Periodontal Maintenance	Payable only if a consecutive 6 month period has passed since the completion of active periodontal surgery. 1 periodontal maintenance or routine prophylaxis procedure per consecutive 6 month period (periodontal maintenance procedure is Class III; routine prophylaxis is Class I)
Crowns	1 per tooth per consecutive 84 month period. Benefits are based on the amount payable for non-precious metals. No porcelain or white/tooth-colored material on molar crown or bridges. Replacement must be indicated by major decay. For participants less than 16, benefits limited to resin or stainless steel
Root Canal Therapy	1 per tooth per lifetime
Wisdom Tooth Extraction	Includes an allowance for local anesthesia and routine postoperative care
Dentures and Partials	1 per arch per consecutive 84 month period
Bridges	1 per consecutive 84 month period. Benefits will be considered for the initial replacement of a Necessary Functioning Natural Tooth extracted while the person was covered under this plan.

Orthodontia

Benefit	DPPO Advantage Network	Out-of-network
Orthodontia Waiting Period	Not applicable	Not applicable
Orthodontia	Not covered	Not covered
Orthodontia Individual Lifetime Maximum	Not applicable	Not applicable

Procedure	Frequency/Limitation
Orthodontia	Not covered under this plan. Discounts may apply.

State-Specific Details

Learn more about the benefits and coverage included in the Cigna Dental 1000 plan by selecting the state where you live:

All State Policy Disclosures, Exclusions, Limitations, and Reductions

This summary contains highlights only and is subject to change.

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^†Monthly rate is based on a single person and represents Cigna's national average rate for each plan using an average age. Valid through December 31, 2018.

¹Not all preventive services are covered, including athletic mouth guards. Refer to the policy for a complete list of covered and non-covered preventive services. Frequency limitations apply.

²For West Virginia customers, 3-month waiting period applies to basic and major restorative services. For Illinois, New Jersey, New Mexico, and Vermont customers, 6-month waiting period applies to basic and major restorative services. For Rhode Island customers, waiting periods do not apply. For Pennsylvania customers, waiting period does not apply to basic restorative services. For all states, any applicable waiting period may be waived with 12 months of continuous prior coverage under a qualified dental plan.

³For North Carolina customers: You pay the difference between the provider's standard fee and 95% of the Maximum Allowable Charge (MAC).

For Massachusetts and Alaska customers: You pay the difference between the provider's standard fee and 100% of the Maximum Reimbursable Charge (MRC).

⁴For Maryland customers, please refer to the Summary of Benefits for Frequency/Limitation information.

⁵For AR, MN, NM, NV and VT customers, coverage is provided for Temporomandibular Joint Dysfunction (TMJ) services, non-surgical, at 50% in network and out of network (plan deductible applies).

⁶The downloading and use of the myCigna® mobile app is subject to the terms and conditions of the app and the online store from which it is downloaded. Standard mobile phone carrier and data usage charges apply.

*Data as of September 2018.

**You may pay more for out-of-network charges if the dentist's charges exceed the amount Cigna reimburses for billed services.

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Disclaimer

Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., and Cigna HealthCare of North Carolina, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Group Universal Life (GUL) insurance plans are insured by CGLIC. Life (other than GUL), accident, critical illness, hospital indemnity, and disability plans are insured or administered by Life Insurance Company of North America, except in NY, where insured plans are offered by Cigna Life Insurance Company of New York (New York, NY). All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.

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Cigna Dental 1000

Benefits of All Cigna Dental Plans

State-Specific Details

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