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Dental Benefits

Medicare-eligible retirees and their eligible spouses may choose from three dental plans. Dental benefits are not included in Medicare or Medicare Supplement Health Plans and must be purchased separately.

All plans offer no cost-share preventive care and three checkups a year when using in-network providers. Cigna offers a choice of providers in their dental network of dentists, endodontists, pediatric dentists, periodontists, orthodontists and other dental providers.

Dental Plan Basic
Restorative 
Services
You Pay
Major
Restorative 
Services
You Pay
Orthodontia
Services
You Pay
Annual 
Deductible
Preventive 20% 99% 99% $0
Basic 15% 50% Not covered
You pay 100%
DPPO Advantage: $0
DPPO and out-of-network:
$50 individual
$150 family 
Dental and
Orthodontia
15% 15% 50%
(up to the $1,500 separate lifetime maximum)
DPPO Advantage: $0
DPPO and out-of-network:
$25 individual
$75 family 

Please note: Preventive procedures are not subject to the annual out-of-pocket limit.

Early retirees may choose to enroll in a dental plan if offered through their former employer.

For detailed descriptions of our three dental plans, download our Dental Plan Handbook.

Health benefits are offered through plans maintained by Church Pension Group Services Corporation (doing business as The Episcopal Church Medical Trust), 19 East 34th Street, New York, NY 10016.

The Episcopal Church Medical Trust Disclaimer

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(855) 215-5990
Monday – Friday
8:30AM – 8:00PM ET
(excluding holidays)

Fax Number
(877) 4-FAX-CPG
(877) 432-9274

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