B2B OHIP Page

*Customers do not have to meet DPPO or indemnity deductible to receive reimbursement for these services. However, reimbursement will apply to and is subject to the annual benefits maximum for traditional indemnity and DPPO plans as well as plan rules for visits to network dentists and out-of-network dentists. **"Preventive Dental Treatment Associated with Lower Medical Utilization and Costs." National study of Cigna customers with dental and medical coverage, updated December 2020. First-year TMC savings 6%, second year +2%, third year + 2.2% for cumulative savings of 10.2% over three years. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company (CHLIC), Connecticut General Life Insurance Company (CGLIC), Cigna HealthCare of Connecticut, Inc., Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and Cigna Dental Health, Inc. and its subsidiaries, including 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, Floas, Inc., Cigna Dental Health of Kentucky, Inc., 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 Texas, the insured dental plan is known as Cigna Dental Choice, and this plan uses the national Cigna DPPO network. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. Policy forms: OK – Indemnity/DPPO: HP-POL99 (CHLIC) and GM6000 ELI288 et al (CGLIC), DHMO: POL115 (CHLIC) and GM6000 DEN201V1 (CGLIC); TN – Indemnity/DPPO: HP-POL69/HC-CER2V1 et al, DHMO: HP-POL134/HC-CER17V1 et al (CHLIC). The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. 958222 06/21 © 2021 Cigna

Improved health starts with the mouth.

Cigna Dental Oral Health Integration Program

This program is for customers with certain medical conditions that have been found to be associated with gum disease and other oral health conditions. The Cigna Dental Oral Health Integration Program reimburses out-of-pocket costs for specific dental services used to treat gum disease and tooth decay. There's no additional cost for the program - if employees qualify and enroll, they get reimbursed!*

Maternity

How pregnancy and oral health are connected. Gum Disease Changing hormones can aggravate inflammation and cause gums to become red and swollen. Between 60 and 75% of pregnant women have gingivitis,* and if it goes untreated, the bone that supports the teeth can be lost and the gums can become infected. Gingivitis can advance to periodontitis, which can cause poor pregnancy outcomes, including preterm birth and low birth weight. Cavities Pregnant women may also be at risk for cavities due to changes in behaviors, such as eating habits. One in four women of childbearing age have untreated cavities.* Impact to baby Children of mothers who have high levels of untreated cavities or tooth loss are more than three times more likely to have cavities.*

Diabetes

How diabetes and oral health are connected. Periodontal Disease If your diabetes isn’t under control, you’re more prone to periodontal disease, which is an infection of the gum and bone that hold your teeth in place. It can cause pain, stubborn bad breath and tooth loss and make your blood sugar harder to control. Thrush Diabetes increases the level of sugar (glucose) in your saliva, which can lead to thrush, a fungal infection that causes painful white patches in your mouth. Dry Mouth When you don’t have enough saliva or have high glucose levels, you can get dry mouth, which causes soreness, ulcers, infections and tooth decay.

Heart Disease

Stroke

Diabetes

Maternity

Kidney Disease

Organ Transplant

Radiation - Head/Neck Cancers

Sjogren's Syndrome

Lupus

Parkinson's Disease

Amyotrophic Lateral Sclerosis (ALS)

Opioid Misuse/Addiction

Rheumatoid Arthritis

How oral health and heart disease are connected. Gum Disease If bacteria stays on your teeth for too long, tartar and plaque start to form. Once it builds up and reaches your gums, it can lead to gingivitis (early gum disease), which causes red, swollen or bleeding gums. Gingivitis can progress to periodontitis (severe gum disease), which can destroy your jawbone and lead to serious infection beyond your mouth. Plaque Bacteria enter your bloodstream through your gums and become part of fatty plaques in blood vessels. When fatty plaques block a blood vessel leading to the heart, it can lead to a heart attack. When fatty plaques reach the brain and cut off its blood supply, it causes a stroke. That’s why it’s important to treat plaque at the source. Inflammation Inflammation starts a cycle: blood vessels swell, which reduces blood flow to the heart, which raises blood pressure, which affects the flow of blood and oxygen to the brain.

What's eligible for reimbursement

Rheumatoid Arthritis

How rheumatoid arthritis and oral health are connected. Gum Disease Tartar and plaque buildup can lead to gingivitis (early gum disease), which causes bleeding gums. Left untreated, it becomes periodontitis (severe gum disease), which can cause serious infection. Inflammation Patients with RA tend to have a higher level of an oral bacteria that triggers the production of proteins that the immune system attacks as foreign. Scientists believe the inflammatory response to the bacteria may spread throughout the body, triggering RA symptoms. Dry Mouth Dry mouth is one of the most common symptoms of Sjogren’s Syndrome which is often found in RA patients and can lead to mouth sores, gum disease and tooth decay.

What's eligible for reimbursement

Opioid Misuse and Addiction

How opioid misuse/addiction and oral health are connected. Dry Mouth A side effect of opioids is dry mouth, which, when combined with increased sugar consumption, can even change the composition of saliva to make it more destructive.* This may lead to mouth sores, gum disease and tooth decay if it’s not addressed early.** Acid Reflux Opioids reduce a barrier in the esophagus that helps protect against acid reflux. The more that acids reach the teeth, the higher the chance of damaging the tooth enamel and gum tissues.**

What's eligible for reimbursement

Amyotrophic Lateral Sclerosis (ALS)

How ALS and oral health are connected. Trouble Maintaining Dental Routines Since ALS affects the functioning of the hands and arms, brushing and flossing aren’t as easy as they used to be and it’s more difficult to keep the mouth clean. Dry Mouth Mouth breathing, BIPAP use and certain ALS medications can cause dry mouth, which can lead to mouth sores, gum disease and tooth decay. Difficulty Swallowing If saliva isn’t swallowed, it accumulates in the mouth. This causes plaque and bacteria to build up and can lead to cavities, gum disease and, if bacteria enters the lungs, pneumonia.

What's eligible for reimbursement

Parkinson's Disease

How Parkinson's Disease and oral health are connected. Trouble Chewing and Swallowing Parkinson’s can cause stiffness in the jaw muscles and make it difficult to chew and swallow.* This makes it harder to break down food, which can lead to cavities and even pneumonia.** Saliva Irregularities Some people with Parkinson’s swallow less, which causes saliva to pool in the mouth and can lead to teeth problems and mouth infections. Others experience dry mouth as a side effect from medications, which can lead to tooth decay and mouth sores.** Periodontitis People with Parkinson’s are more likely to have bacteria that’s associated with periodontitis (severe gum disease). These bacteria can cause bleeding, pain and damage to the gums and easily infiltrate the bloodstream to harm other parts of the body.***

What's eligible for reimbursement

Lupus

How lupus and oral health are connected. Ulcers As many as 45% of people living with lupus can have either acute or chronic ulcers or lesions on the lips, on the tongue and inside of the mouth.* Ulcers are especially common during “flare-ups.” Periodontitis People with lupus are more likely to struggle with periodontitis (severe gum disease), which is particularly concerning because of the link between gum inflammation and the overall health of the rest of the body.** Dry Mouth Lupus attacks saliva-producing glands, and some medications cause dry mouth as a side effect, which can lead to mouth sores, gum disease and tooth decay. Fluoride treatments can help counter the damage.

What's eligible for reimbursement

Sjogren's Syndrome

How Sjogren's Syndrome and oral health are connected. Dry Mouth Dry mouth is one of the most common symptoms of Sjogren’s Syndrome and can lead to mouth sores, gum di*ease and tooth decay if it’s not addressed early. Oral Sensitivity Sjogren’s Syndrome makes it harder to chew certain foods and more uncomfortable to brush. But it’s important to maintain oral hygiene to counteract the lack of protection from decreased saliva. Thrush Since Sjogren’s Syndrome is an autoimmune disease, it can disrupt the balance of microorganisms in the mouth and lead to a yeast infection. Stay on top of thrush to prevent it from spreading to other parts of the body.

What's eligible for reimbursement

Radiation - Head and Neck Cancers

How head and neck cancer radiation and oral health are connected. Oral Mucositis Head and neck cancer treatment can make the tissue in your mouth swell, break down and form ulcers. It’s painful and can cause bleeding. Healing takes 2-4 weeks after chemotherapy and 6-8 weeks after radiation. Dry Mouth Head and neck chemotherapy and radiation damage the salivary glands and cause dry mouth, which can lead to mouth sores, gum disease and tooth decay. Jaw Problems The causes of jaw issues are twofold: loss of tissue and bone from treatment, and the growth of benign tumors. This can make it hard to eat and drink, which can cause further problems, such as malnutrition and dehydration.

What's eligible for reimbursement

Organ Transplant

How organ transplants and oral health are connected. Gum Disease Anti-rejection medications make it harder to fight off bacteria, which can lead to gingivitis (early gum disease), which causes red, swollen or bleeding gums. Gingivitis can progress to periodontitis (severe gum disease), which can destroy your jawbone and lead to serious infection beyond your mouth. Dry Mouth Anti-rejection medications suppress the immune system and cause dry mouth, which can lead to mouth sores, gum disease and tooth decay. Ulcers Anti-rejection medications also make the mouth lining more susceptible to sores that can make chewing, speaking or swallowing painful.

What's eligible for reimbursement

Kidney Disease

How kidney disease and oral health are connected. Gum Disease If bacteria stays on your teeth for too long, tartar and plaque can form. Once it reaches your gums, it can lead to gingivitis (early gum disease), which causes red, swollen or bleeding gums. Gingivitis can progress to periodontitis (severe gum disease), which can destroy your jawbone and lead to serious infection beyond your mouth, especially if your immune system is weakened from kidney disease. Inflammation Cavities and gum diseases are chronic bacterial infections that cause pain, difficulty eating and harmful chronic inflammation. If you have chronic kidney disease, this inflammation can lead to heart disease, so it’s key to treat it at the source. Transplant delays Medications to prevent kidney rejection further weaken the body’s defenses against infection. Taking care of any oral infections beforehand allows the transplant to proceed as planned.

What's eligible for reimbursement

Eligible conditions

Click on each condition name for more information

Huntington's Disease

How Huntington's Disease and oral health are connected. Trouble Maintaining Dental Routines Huntington’s Disease affects the functioning of the hands and arms, making it more difficult to brush, floss and keep the mouth clean. Preventive care can help. Tooth Decay Since many people with Huntington’s disease benefit from a high-energy (and high-sugar) diet, they’re more susceptible to tooth decay. It’s important to stay on top of dental hygiene because chorea in the state stages of the disease requires anesthesia for routine procedures and brings a higher risk for pulmonary aspiration. Bruxism Bruxism is the grinding and clenching of teeth and can be part of the involuntary movements seen in typical patients with Huntington’s Disease. It can lead to pain, tooth fractures, headaches and TMJ.

What's eligible for reimbursement

Huntington's Disease

QUESTIONS?

Frequently Asked Questions

Do I only have to enroll in the program once or, do I have to contact Cigna each time I go to the dentist? You only enroll once in the program. Once enrolled, Cigna will automatically reimburse you for the eligible dental services covered for your medical condition. How and when will I get reimbursed for my out-of-pocket expenses? As with any dental service, you will pay your dentist at the time the service is performed. A claim form is typically submitted to Cigna by your dentist. Once we receive the claim form from the dentist, we pay him/her for their services and you will then receive reimbursement for the amount of your coinsurance or copay. This may take 2-4 weeks, depending on when the dentist submits the claim. Please keep in mind that only dental services eligible under the Cigna Dental Oral Health Integration Program will be reimbursed. How do I know if my enrollment has been processed? Once your enrollment has been approved, Cigna will send you a program welcome letter. What procedures are eligible for reimbursement? Please refer to the list of procedures for each qualifying condition on the homepage. If my dental coverage has a plan maximum or deductible, how do procedures covered under the program get applied? Any procedures covered under the program are not applied toward your plan's annual deductible; however, they do count towards your plan's annual maximum. If I go out-of-network, will the services covered under this program still apply? If your plan does not include coverage for out-of-network services, then you must use a dentist in your plan's network for coverage under this program to apply. If your plan includes out-of-network coverage, you will be reimbursed for your covered expenses whether you choose to use an in-network or out-of-network dentist. However, if you use an out-of-network dentist you may have out-of-pocket costs because the dentist may choose to bill you for charges that are in excess of what your plan reimburses for covered expenses. If I'm a dependent (spouse, partner or child), do I provide my ID number or the person who is the primary covered individual? Please provide the ID number of the person who is the primary covered individual. Where can I find my Group/Account Number? Please check a previous Explanation of Benefits, your dental page on mycigna.com, call Customer Service at the number on your ID card and follow the prompts to get your Group/Account Number. You can also provide your ID and/or social security number and a Customer Service Representative will identify your Group/Account Number for you. If you have a Cigna Medical or Dental ID card the Group/Account Number is listed on the cards. If I don't have an e-mail address but still want information on behavioral conditions affecting my oral health, how can I get the information? Please include a note when you submit your Cigna Dental Oral Health Integration Registration Form indicating the address where you would like the information mailed and it will be sent through the U.S. Postal Service. Do I have to include anything that proves I have a condition and does Cigna have the right to verify my condition? You do not have to include any documentation with your Registration Form that proves you have a specific condition. However, at the bottom of the form you must sign your name verifying that you have the condition and acknowledge that Cigna reserves the right to request medical records or check with your physician prior to reimbursement. If I have questions about the Cigna Dental Oral Health Integration Program or how to complete and submit the Registration Form who do I call? Please call Customer Service at the number on your ID card with any questions. One of our associates will be happy to help you, 24 hours a day, 7 days a week.

*Colgate. (n.d.). Lupus Symptoms and Oral Health. www.colgate.com/en-us/oral-health/immune-disorders/lupus-symtoms-and-oral-health **ProHEALTH Dental. (2019, May 23). Lupus Your Oral Health. www.phdental.com/patient-resources/oral-health-news/2019/may/lupus-your-oralhealth

*Titsas, A, and Ferguson, MM. (2002). Impact of opioid use on dentistry. Australian Dental Journal 2002;47:(2):94-98. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1834-7819.2002.tb00311.x **American Addiction Centers. (2020, February 3). How Drug Abuse Affects Dental Health. https://americanaddictioncenters.org/health-complications-addiction/dental-health

*Ellis, Sarah. (2020, July 28). The Link Between Rheumatoid Arthritis and Dental Health. HealthCentral, www.healthcentral.com/slideshow/link-between-dental-health-and-rheumatoid-arthritis **Johns Hopkins Arthritis Center. (2016, January 11). Dental Tips for the Rheumatoid Arthritis Patient. www.hopkinsarthritis.org/arthritis-news/5-dental-tips-forthe-ra-patient

*Parkinson’s Victoria Ltd. (n.d.). Eating, Swallowing and Saliva Management. www.parkinsonsvic.org.au/parkinsons-and-you/eating-swallowing-and-saliva-management **Parkinson’s Foundation. (n.d.). Dental Health. www.parkinson.org/Living-with-Parkinsons/Managing-Parkinsons/Dental-Health ***Adams B, Nunes JM, Page, MJ, et al. (2019, August 27). Parkinson’s Disease: A Systemic Inflammatory Disease Accompanied by Bacterial Inflammagens. Frontiers in Aging Neuroscience. www.frontiersin.org/articles/10.3389/fnagi.2019.00210/full

Stroke

How oral health and strokes are connected. Gum Disease If bacteria stays on your teeth for too long, tartar and plaque start to form. Once it builds up and reaches your gums, it can lead to gingivitis (early gum disease), which causes red, swollen or bleeding gums. Gingivitis can progress to periodontitis (severe gum disease), which can destroy your jawbone and lead to serious infection beyond your mouth. Plaque Bacteria enter your bloodstream through your gums and become part of fatty plaques in blood vessels. When fatty plaques block a blood vessel leading to the heart, it can lead to a heart attack. When fatty plaques reach the brain and cut off its blood supply, it causes a stroke. That’s why it’s important to treat plaque at the source. Inflammation Inflammation starts a cycle: blood vessels swell, which reduces blood flow to the heart, which raises blood pressure, which affects the flow of blood and oxygen to the brain.

What's eligible for reimbursement

*Centers for Disease Control and Prevention (CDC). (2019, February 19). Pregnancy and Oral Health. www.cdc.gov/oralhealth/publications/features/pregnancy-and-oralhealth.

One whole-mouth periodontal (Gum) treatment every 24 months Two additional periodontal (Gum) maintenance procedures Codes: D4341, D4342, D4910

One Whole-Mouth Periodontal (Gum) Treatment Every 24 Months Two Additional Periodontal (Gum) Maintenance Procedures One Additional Oral Evaluation One Periodontal Evaluation One Additional Cleaning One Additional Full-Mouth Scaling Unlimited Palliative Treatment Codes: D4341, D4342, D4910, D0180, D0120, D0140, D0150, D1110, D4346, D9110

One whole-mouth periodontal (Gum) treatment every 24 months Two additional periodontal (Gum) maintenance procedures One topical application of fluoride varnish Sealants and sealant repair - one treatment per tooth every 36 months Tooth decay/cavity prevention - two treatments per tooth per year Codes: D4341, D4342, D4910, D1206, D1208, D1351, D1353, D1354, D1355

One whole-mouth periodontal (Gum) treatment every 24 months Two additional periodontal (Gum) maintenance procedures One topical application of fluoride varnish Sealants and sealant repair - one treatment per tooth every 36 months Tooth decay/cavity prevention - two treatments per tooth per year One additional oral evaluation Codes: D0120, D0140, D0150, D4341, D4342, D4910, D1206, D1208, D1351, D1353, D1354, D1355

One whole-mouth periodontal (Gum) treatment every 24 months Two additional periodontal (Gum) maintenance procedures Codes: D4341, D4342, D4910

A Cigna Dental Health Connect Solution

Enrolled employee visits their dentist and pays their usual copay or coinsurance for the covered service. If they visit a Cigna network dentist, the dentist will file the claim. If they visit an out-of-network dentist, the employee may need to file the claim. Cigna receives the claim and mails a reimbursement for eligible dental services in about 30 days.

Reimbursement is as simple as 1, 2, 3...

1. 2. 3.

Preventive dental care can help lower medical costs and promote positive outcomes.**

No chronic condition Diabetes

Medical conditions

Medical cost savings

10.2% TMC PMPY 12.25% TMC PMPY

31%

savings on future dental costs

22%

fewer ER and urgent care visits

What is the Cigna Dental Oral Health Integration Program?

Improved health starts with the mouth.