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Offered by Cigna Health and Life Insurance Company.
The Cigna Dental Oral Health Integration 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 you qualify and enroll, you get reimbursed!
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Cigna Dental Oral Health Integration Program®
Stay healthy from your teeth to your toes.
How your Cigna dental plan can help.
Have questions or need help? Cigna is here for you 24/7/365.
877-505-3682
We're focused on helping you be at your best, body and mind.
Routine dental exams can help detect signs of medical conditions such as diabetes, leukemia, heart disease and kidney disease that sometimes produce oral symptoms.
If you have a chronic medical condition such as diabetes, heart disease or a history of stroke, getting the appropriate preventive dental care is even more important, because studies show a connection between certain chronic conditions and gum disease.¹
Having regular preventive dental check-ups can help you avoid emergency room and urgent care visits. People who don't get regular dental care have 22% more visits to emergency rooms and urgent care centers.²
Cigna DPPO Plan
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Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, review your plan documents. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company (CHLIC) or its affiliates. Policy forms: OR - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 et al. (CHLIC). 927583 04/21 ©2021 Cigna. Some content provided under license.
***This listing is not all-inclusive. For a listing of providers and facilities that participate in the LocalPlus network, contact your Cigna representative or visit Cigna.com.
** As of March 2021. Subject to change.
* Potential savings estimated, based on an internal Cigna study conducted in 2021 comparing Cigna’s LocalPlus plans with Cigna’s Open Access Plus (OAP) plans in Georgia with the same benefit plan provisions. Savings are not guaranteed and will vary depending on plan design, geographic distribution and utilization patterns. Medical cost savings do not directly translate to rate or premium rates.
Find a Total DPPO Network Dentist
Your plan has no annual deductible or dollar maximum on most covered services. However, it is important to understand how care is covered when you use a network dentist versus a non-network dentist.
Network dentists have agreed to provide dental services to Cigna customers at a reduced rate, saving you money on care. They will file claims for you and they cannot "balance bill" you for the difference between their usual fees and what they have agreed to accept from Cigna. Balance billing occurs when the fee the dentist usually charges is more than the amount Cigna pays them.
Out-of-Network dentists do not offer a reduced rate to Cigna customers and you may have to file your own claims. Out-of-network dentists can charge whatever fee they want for services, but Cigna uses a "maximum allowed amount" to determine the reimbursable fee. The "maximum allowable charge" (MAC) is based on a percentile of fees charged by dentists in an area for a specific service. Out-of-network dentists can balance bill you for the difference between their usual fees and the amount Cigna reimburses them.
Why use a Cigna Total DPPO network dentist?
Show me an example
Active Member Benefit Summary
Your Cigna dental plan covers certain preventive dental care services at no additional cost when you use a dentist in the Total DPPO network.***
Bob and Mary both need a root canal.
Mary Out-of-Network Dentist
Bob Network Dentist
Fee for root canal
Percentage of reimbursable fees the plan covers
Reimbursable amount
Plan pays
$850
100%
Contracted Fee $650
MAC $700
$650
$700
Can dentist balance bill?
$150
No
Yes
Mary Pays
$0
Difference between usual fee and MAC.
Bob Pays
Bob uses a network dentist. Mary uses an out-of-network dentist.
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Example for illustrative purposes only.
Retired Member Benefit Summary
Cigna Dental PPO
Plan overview
Although the Cigna Dental PPO (DPPO) plan will pay for covered services performed by dentists who do not participate in our network, you may save money by using a dentist who is in network. In-network dentists file claims on your behalf and apply your coinsurance to their fees which are discounted for Cigna customers.
Choice and Savings
With the Total Cigna DPPO network, you'll be able to choose from over 150,000 dentists*. And if you're not sure where to start with your search, we've made it easy with tools on your personalized myCigna account. You can read verified patient reviews, compare Brighter Scores and view office information and photos**.
A Network of Quality Providers
*Total DPPO network unique provider count for year-end 2021. Subject to change. **Actual features may vary by dentist. These and other dentist directory features are for educational purposes only and should not be the sole basis for decision making. They are not a guarantee of the quality of care that will be provided to individual patients and you should consider all relevant factors when selecting a dentist. ***All group dental insurance policies and dental benefit plans contain exclusions and limitations. For costs and details of coverage, review your plan documents or contact a Cigna representative.
Plan Overview Presentation
DHMO Plan Benefit Summary
Plan overview for retired members only
Cigna Dental Care (DHMO)
The Cigna Dental Care (DHMO¹) plan includes coverage for many procedures - including some that may not be available on your other dental plan options. There are no deductibles to pay before coverage begins, no annual dollar maximums on covered services, no claim forms and no waiting periods.²
The Cigna Dental Care (DHMO) plan covers dental care services when performed by a dentist in the Cigna Dental Care Access Plus Network. The plan offers lower costs because you must use a network dentist for all care. Some exceptions may be made for emergencies and state requirements, so be sure to review your enrollment materials and plan documents carefully.³
You choose a network general dentist (NGD) who will provide all of you routine care. Should you need to see a specialist, your NGD will refer you to one in the network.
• You can change your NGD any time - just call or log on to myCigna • Your enrolled dependents can each choose their own NGD • Children up to the age of 13 can use a pediatric network dentist • Referrals not needed for network orthodontists or pediatric dentists
How the plan works
Learn how a DHMO plan works.
Find a DHMO Access Plus Dentist
We're focused on helping you be at your best, body and mind. That means offering a rich set of benefits - including some services not covered by the DPPO - and programs designed to help you better manage medical conditions through dental care.
*The costs shown include copays for 24-month treatment plan, banding, removal, and treatment plan/records. Your costs may vary depending on what services you need.
PROCEDURE
YOUR COST
Prophylaxis (routine cleaning) Periodic oral evaluation Topical fluoride for all ages Sealants for all ages - per tooth Amalgam filling (silver) 1 - 4 surfaces, any tooth Composite filling (tooth colored) 1 - 3 surfaces, front teeth Composite filling (tooth colored) 1 surface, back teeth Molar root canal (excludes final restoration) Periodontal (gum) scaling & root planing 4+ teeth - per quadrant Periodontal (gum) maintenance Removal/extraction of impacted tooth - soft tissue Removal/extraction of impacted tooth - completely bony Surgical placement of implant - endosteal implant Orthodontics - up to age 19 Orthodontics - age 19 and older Teeth whitening (per arch) Custom Athletic Mouth Guard
Common covered procedures and your costs.
5
View Dental Fee Overview
1. The term “DHMO” is used to refer to product designs that may differ by state of residence of enrollee, including but not limited to, prepaid plans, managed care plans, and plans with open access features. The Cigna Dental Care (DHMO) may not be available in all states. 2. All group dental plans and insurance policies have exclusions and limitations. For costs and details about the services covered under your plan, review your enrollment materials. Dentists who participate in Cigna’s network are independent contractors solely responsible for the treatment provided and are not agents of Cigna. 3. A 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. 4. TMJ-related coverage may be available on your medical plan. 5. This is not a complete list. Actual terms of coverage may vary by state. Exclusions and limitations apply. For a more complete list of both covered and not covered services, including benefits required by your state, refer to the rest of your enrollment materials or call 800.Cigna24 (800.244.6224) if you have questions or need more information.
$0 $0 $0 $12 $0 $0 $47 $335 $83 $53 $46 $115 $1,025 $3,162* $3,498* $165 $110
DHMO Plan FAQs
Q1: Can I go to any dentist? A1: Except for emergencies or where required by law, you must use a dentist in the Access Plus network for care to be covered.* Q2: What if my current dentist does not participate in the Cigna network? A2: While many dentists participate in the Access Plus network (approximately 30,000 nationwide**), if you would like to see a dentist who does not participate, you can call Cigna to request a provider nomination form. Q3: Do I choose a dentist when I sign up for the plan? A3: You will need to choose a network dentist to service as your primary provider. You can choose a network dentist online at Cigna.com before you sign up, or go to your personalized website at myCigna.com after you sign up. You can also call Cigna’s 24/7/365 dedicated toll free number at 800-Cigna24, and we will help you find a network dentist in your area. Q4: Do I need a referral to see a specialist? A4: With the exception of network orthodontists and pediatric specialists for children under the age of 13, your primary network dentist must refer you to specialists for care when appropriate. Q5: Can I download my ID card to my device? A5: Yes. You will be receiving ID cards in the mail; however, once you are registered on the myCigna.com Home page you will see “ID Cards.” The “ID Cards” icon is usually on the bottom left of a smart phone and top right on a computer. Q6: What if it's 3:00am and I urgently need dental care? A6: Virtual dental care is available 24/7/365. You must first log onto myCigna.com to have access to our virtual dental care. Once you are in myCigna.com follow the prompts to the virtual care portal. This will take you to “TheTeleDentists” website where you will need to create an account. Afterwards, you will be able to receive virtual urgent dental care. Please note that the dentist must be able to see you from your device. Q7: Is orthodontia coverage available to eligible children and adults? A7: Yes.
Frequently Asked Questions
Have questions? Call Cigna at 877-505-3682
Active Member DPPO Benefit Summary
Retired Member DPPO Benefit Summary
Retired Member DHMO Benefit Summary
DPPO Plan FAQs
Active and Retired Members
Retired Members Only
Q1: Can I go to any dentist? A1: Yes. You will typically spend less when you visit a Cigna network dentist because Cigna has negotiated discounted rates with these dentists. The national dental network is called “Total Cigna DPPO (Cigna DPPO Advantage and Cigna DPPO)”. When you use a Total Cigna DPPO (Cigna DPPO Advantage/Cigna DPPO) network dentist you’ll save as long as the procedure is listed on the dentist’s discount schedule. If you use a non-network dentist, you will not receive Cigna network discounts and the dentist may bill you for the difference between the payment they receive from Cigna and their usual fees. Q2: What if my current dentist does not participate in the Cigna network? A2: While most in-network dentists currently used by members and their families are part of Cigna’s extensive national network, a small number are not. You may go to cigna.com to see if your dentist is participating, or you can call Cigna to request a provider nomination form. Q3: How are non-network dentists reimbursed under the new Cigna plan? A3: Non-network dentists are reimbursed based on a Maximum Allowable Charge (MAC) schedule. Cigna will reimburse covered services at 100% of the Maximum Allowable Charge. There will be no charge to you if the non-network dentist accepts Cigna’s paid amount as payment in full. However, non-network dentists may balance bill you for the difference between Cigna’s payment and their usual fee. A quick example of how in-network vs non-network dentists are reimbursed is as follows; Q4: Do I choose a dentist when I sign up for the plan? A4: No, you are free to see any network or non-network dentist (general dentist or specialist) without notifying Cigna in advance. You can find a network dentist or specialist online at Cigna.com before you sign up, or go to your personalized website at myCigna.com after you sign up. You can also call Cigna’s 24/7/365 dedicated toll free number at 800-Cigna24, and we will help you find a network dentist in your area. Q5: Do I pay up front and submit a claim or will the dentist submit claims for me? A5: In most instances, if you are using an in-network dentist, they will submit claims on your behalf. Cigna accepts electronic claims from non-network dentists, however a non-network dentist may require you to file your own claims after payment if they choose not to file on your behalf. Q6: Can I download my ID card to my device? A6: Yes. You will be receiving ID cards in the mail; however, once you are registered on the myCigna.com Home page you will see “ID Cards.” The “ID Cards” icon is usually on the bottom left of a smart phone and top right on a computer. Q7: What if it's 3:00am and I urgently need dental care? A7: Virtual dental care is available 24/7/365. You must first log onto myCigna.com to have access to our virtual dental care. Once you are in myCigna.com follow the prompts to the virtual care portal. This will take you to “TheTeleDentists” website where you will need to create an account. Afterwards, you will be able to receive virtual urgent dental care. Please note that the dentist must be able to see you from your device. Q8: Do I need a referral to see a dental specialist? A8: No. However we do suggest seeing an in-network dentist, if possible, to save money. Q9: How many dentists are in the Cigna network? A9: Cigna has over 150,000 dentists in their Total Cigna DPPO network. Q10: Is orthodontia coverage available to eligible children and adults? A10: Yes.
Select which plan you would like to learn about by clicking on "DPPO Plan FAQs" or "DHMO Plan FAQs"
