Resources‎ > ‎

Cigna Dental

 
PLAN FEATURES

IN-NETWORK

OUT-OF-NETWORK
Calendar Year Maximum Benefit
$2,000
$2,000
Calendar Year Deductible: Individual
$50 $50
Calendar Year Deductible: Family
$150  $150
CLASS I - PREVENTIVE & DIAGNOSTIC CARE

Oral Exams (2 per year)
Routine Cleanings (2 per year)
X-rays (Routine, Bitewings)
X-rays (Non-Routine, Full Mouth, Panoramic)
Fluoride Application
Sealants
Space Maintainers
Emergency Care to Relieve Pain
100% no deductible 100% no deductible *
CLASS II - BASIC RESTORATIVE CARE

Fillings 
Root Canal Therapy/Endodontics
Osseous Surgery 
Periodontal Scaling and Root Planing 
Denture Adjustments and Repairs 
Oral Surgery - Simple Extractions 
Oral Surgery - All Except Extractions
Anesthetics
Surgical Extractions of Impacted Teeth
Repairs to Bridges, Crowns and Inlays
90% after deductible 80% after deductible *
CLASS III - MAJOR RESTORATIVE CARE    
Crowns
Dentures
Bridges
Inlays - Onlays
Prosthesis Over Implant
65% after deductible  50% after deductible *
CLASS IV - ORTHODONTICS     
Coverage for Adults and Children
50% no separate deductible 50% no separate deductible *
Lifetime Maximum Orthodontia Benefit
$2,000
$2,000

* For covered services provided by an out-of-network dentist, Cigna Dental reimburses according to what is considered Usual, Customary, and Reasonable (UCR) for a given procedure in a given area. Often the UCR amount for a given procedure is less than the amount typically charged by an out-of-network dentist