Dental

• Essential Dental Plan: Based on the plan’s maximum allowed charges. You may be balance-billed above that amount.
  
• Enhanced Dental Plan: Reimburses up to 90% of reasonable and customary for non-participating providers/services.
  

Go to mycigna.com, log in, → Find Care, → search by dentist name, specialty, or location. Using Cigna Total DPPO dentists helps you save and maximize benefits.

Dental Virtual Care (24/7/365)

If you cannot reach your dentist, you can connect with a licensed dentist by video through myCigna → virtual care portal. No copay or coinsurance for the consult; visits count toward any frequency limits and your annual dental maximum.

Note: Dentists cannot prescribe opioids or narcotics. Video chat may not be available in all areas.

Cigna Dental Oral Health Integration Program (OHIP)

If you have certain medical conditions, OHIP reimburses out-of-pocket costs for select preventive dental treatments at no additional program cost. You must have a Cigna dental plan, but you do not need Cigna medical. Enroll at myCigna → Coverage → Dental, or call the number on your ID card. Reimbursements for eligible services are typically mailed in about 30 days.

Examples of covered services include extra cleanings or evaluations, added periodontal treatments, fluoride, sealants, and palliative treatment, subject to plan limits and annual maximums.

Preventive Care: Routine services that help you stay healthy. When in network and meeting guidelines, these are typically covered at no cost to you.

Deductible: What you pay for covered services before the plan starts sharing costs.

Premium: The amount you pay for your health insurance coverage, deducted from your paycheck each pay period. This is what you pay to have coverage, regardless of whether you use medical services. Your premium is separate from deductibles, copays, and coinsurance.

Coinsurance: The percentage you pay for covered services after you meet your deductible.

Copayment (Copay): A fixed amount you pay for a covered service at the time of service. For example, a $30 copay for a doctor's visit or $10 for a generic prescription. Common in the Premium POS plan.

In-Network Care: In-network providers offer services at negotiated rates, resulting in cost savings for you.

Out-of-Network Care: When you receive care outside the plan’s network, you may experience higher costs and balance billing. While you still have the option to seek care outside the network, it’s important to be aware of the financial implications.

Out-of-Pocket Maximum (OOPM): The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.