When you mainly want coverage for dental check-ups, Cigna Dental Preventive is an affordable choice. Cigna pays 100 percent for cleanings, exams and routine x-rays1 when you visit a Cigna Dental Preferred Provider Organization (DPPO) Advantage provider, and there are no deductibles or annual benefit maximums for these services.
With this flexible dental PPO plan, you can see any dentist, but you’ll be 100 percent covered for preventive and diagnostic services2 when you choose from Cigna's national network of over 90,000 unique dentists at over 286,000 locations.*, **
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 claim filling 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 Oral Health Integration Program® for pregnant women and people with certain health conditions.
- Digital tools for members, including the myCigna® mobile app.6
- 24/7/365 live customer service, when and where you need it: 1-800-997-1654
| Benefit | DPPO Advantage Network | Out-of-network |
|---|---|---|
|
Individual Calendar Year Deductible |
Not applicable |
Not applicable |
|
Family Calendar Year Deductible |
Not applicable |
Not applicable |
|
Calendar Year Benefit Maximum |
Not applicable |
Not applicable |
| 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 |
| Benefit | DPPO Advantage Network | Out-of-network |
|---|---|---|
|
Basic Restorative Services Waiting Period |
Not applicable |
Not applicable |
|
Basic Restorative Services (Fillings, non-routine x-rays) |
You pay 100% of the provider's standard fee |
You pay 100% of the provider’s standard fee |
| Procedure | Frequency/Limitation5 |
|---|---|
|
Fillings |
Not covered under this plan. |
|
Non-routine X-Rays |
Not covered under this plan. |
|
Routine Tooth Extraction |
Not covered under this plan. |
|
Emergency Treatment |
Paid as a separate benefit only if no other service, except x-rays, is rendered during the visit |
| Benefit | DPPO Advantage Network | Out-of-network |
|---|---|---|
|
Major Restorative Services Waiting Period |
Not applicable |
Not applicable |
|
Major Restorative Services5 |
You pay 100% of the provider's standard fee5 |
You pay 100% of the provider’s standard fee
|
| Procedure | Frequency/Limitation4 |
|---|---|
|
Periodontal (Deep Cleaning) |
Not covered under this plan. |
|
Periodontal Maintenance |
Not covered under this plan. |
|
Crowns |
Not covered under this plan. |
|
Root Canal Therapy |
Not covered under this plan. |
|
Wisdom Tooth Extraction |
Not covered under this plan. |
|
Dentures and Partials |
Not covered under this plan. |
|
Bridges |
Not covered under this plan. |
| Benefit | DPPO Advantage Network | Out-of-network |
|---|---|---|
|
Orthodontia Waiting Period |
Not applicable |
Not applicable |
|
Orthodontia |
You pay 100% of the provider's standard fee |
You pay 100% of the provider’s standard fee |
|
Orthodontia Individual Lifetime Maximum |
Not applicable |
Not applicable |
| Procedure | Frequency/Limitation |
|---|---|
|
Orthodontia |
Not covered under this plan. |
State-Specific Details
Learn more about the benefits and coverage included in the Cigna Dental Preventive 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.
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.
1Frequency limitations apply.
2Not 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.
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.
This summary contains highlights only and is subject to change.