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Dental Health Maintenance Organization (DHMO) Plans

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Cigna Dental Care (DHMO)

What is the Cigna Dental Care® (DHMO) Plan?

The Cigna Dental Care (DHMO)1 plan requires you to select a general dentist for routine, preventive, diagnostic and emergency care.2 They will refer you to specialists as needed.

If you choose a Cigna Dental Care plan, it’s important to know how it works.3

  • This plan covers most preventive and diagnostic services at a competitive rate, or at no extra cost. 4
  • Once your coverage begins, you can easily search for network providers in the directory on myCigna.com. Before enrollment, you can also review your plan materials or ask your employer which network is offered with your plan and search the dentist directory on Cigna.com.
  • Dependents under age seven do not need a referral to see a network primary pediatric dentist. After age seven, covered services must be received from a network primary care general dentist.2
  • If the Cigna Dental Care plan chosen by your employer includes coverage for orthodontic services, you can see an in-network orthodontist without a referral.5
  • During enrollment, refer to the Dental Fee Overview for a summary of covered services and patient charges as well as plan exclusions and limitations.
  • Cigna Dental Care plans don't have a deductible or a yearly dollar limit. There is also no coverage waiting period.
  • After you enroll, refer to the Patient Charge Schedule (PCS) for a list of detailed cost and copays for all covered services received from network dentists.
    • This plan does not have out-of-network coverage, except for emergency dental care (as defined by your plan documents) or where required by state law.2

1The term “DHMO” is used to refer to product designs that can vary depending on your state, including but not limited to, prepaid plans, managed care plans and plans with open access features. The Cigna Dental Care plan is not available in all states.

2A benefit is paid for covered out-of-network emergency dental care. Certain states mandate coverage for dental care received out-of-network. For example, in Minnesota, the plan will pay 50% of the value of your network benefit for covered out-of-network services. In Oklahoma, the plan will pay the same amount it pays network dentists for covered out-of-network services. You are responsible for any charges not covered by the plan. Other states may have similar mandates. Refer to your plan documents for cost and coverage details.

3Please refer to your plan documents or contact your employer for more information on what out-of- pocket costs you may be responsible for and what’s covered and not covered by your employer’s specific plan.

4Not all preventive care services are covered. For example, prescription medications are generally not covered. Most plans limit cleanings and bitewing x-rays to two (2) per calendar year, and full mouth/panorex x-rays to one (1) every three calendar years. Plans may vary so see your Dental Fee Overview for a summary of covered preventive care services.

5Refer to your plan materials to see if your plan includes orthodontic coverage. The following orthodontic services are generally not covered: incremental costs associated with optional/elective materials; orthognathic surgery appliances to guide minor tooth movement or correct harmful habits; and any services which are not typically included in orthodontic treatment.

All group dental insurance policies and dental benefit plans contain exclusions and limitations. For costs and details of coverage, see your plan documents. Cigna Dental Care plans are insured by Cigna Dental Health Plan of Arizona, Inc., Cigna Dental Health of California, Inc., Cigna Dental Health of Colorado, Inc., Cigna Dental Health of Delaware, Inc., Cigna Dental Health of Florida, Inc., a Prepaid Limited Health Services Organization licensed under Chapter 636, Florida Statutes, Cigna Dental Health of Kansas, Inc. (KS & NE), Cigna Dental Health of Kentucky, Inc. (KY & IL), Cigna Dental Health of Maryland, Inc., Cigna Dental Health of Missouri, Inc., Cigna Dental Health of New Jersey, Inc., Cigna Dental Health of North Carolina, Inc., Cigna Dental Health of Ohio, Inc., Cigna Dental Health of Pennsylvania, Inc., Cigna Dental Health of Texas, Inc., and Cigna Dental Health of Virginia, Inc. In other states, Cigna Dental Care plans are insured by Cigna Health and Life Insurance Company (CHLIC) or Cigna HealthCare of Connecticut, Inc., and administered by Cigna Dental Health, Inc. Policy forms: OK - POL115, OR - HP-POL121 04-10, TN – HP-POL134/HC-CER17V1 et al (CHLIC).