Cigna Dental Plans Going Away
Coverage with Cigna Dental through the Medical Trust will not be offered after December 31, 2023.
Our new vendor for dental coverage will be Delta Dental, effective January 1, 2024.
Dental & Orthodontia PPO
The Dental & Orthodontia PPO (DPPO) plan includes most preventive procedures at low or no cost to you. Preventive procedures are not subject to the annual maximum. You pay 15% coinsurance on basic and major restorative services, which are subject to the annual maximum, and 50% coinsurance on orthodontia services subject to the lifetime orthodontia maximum.
The coverage includes:
- DPPO and Out-of-Network Annual Deductible: $25 individual, $75 family
- Annual Benefit Maximum: $2,000 individual
- Lifetime Orthodontic Maximum: $1,500 individual
- Dental implants and medically necessary night guards are included as covered major services (plan pays 85%) and count towards the annual benefit maximum
- Preventive procedures are not subject to the annual benefit maximum.
| Service |
Your Cost |
|---|---|
|
Preventive & Diagnostic Services
|
DPPO Advantage Provider: 0% DPPO & Out-of-Network Provider: 0%1
|
|
Basic Restorative Services
|
DPPO Advantage Provider: 15% DPPO & Out-of-Network Provider: 15%1
|
|
Major Restorative Services
|
DPPO Advantage Provider: 15% DPPO & Out-of-Network Provider: 15%1
|
|
Orthodontia
|
DPPO Advantage Provider: 50% DPPO & Out-of-Network Provider: 50% (up to the $1,500 separate lifetime maximum)1
|
For detailed descriptions of our three dental plans, download our Cigna Dental Handbook.
View the plan summary:
1 If the provider’s fees exceed the regular and customary charges allowed in the plan, you may be billed for the balance.