Dental Benefits

What you need to know

The Cigna Dental Option 1 (Basic) plan covers all your dental needs, from routine exams and cleanings to major services like bridgework and crowns and orthodontia. Although you may see any dentist you like, when you visit a network dentist, you’ll pay less and you won’t have to file a claim.

Find a participating dentist

The Cigna website makes it simple to locate a participating dentist in your area.

Plan Features

The Cigna Dental Option 1 plan features:

  • A nationwide network of Cigna dentists
  • Discounted rates for using participating Cigna network dentists
  • Preventive services at no cost to you
  • Coverage for restorative services

You can also choose to waive dental coverage.

Know before you go
Before you sit down for a procedure that will cost more than $200, contact Cigna to request a pretreatment review of benefits. That way, you’ll know how much the plan will cover and how much you’ll need to pay.

What You Pay for Care

In-Network
Out-of-Network*
Annual Deductible**
Individual: $50
Family: $150
Individual: $50
Family: $150
Individual Maximum Calendar-Year Benefit** (excludes orthodontia)
$1,200
$1,200
Preventive & Diagnostic Care Services (no deductible) includes routine exams, cleanings, x rays, sealants, and other services
0%
0%
Basic Restorative Care such as fillings, oral surgery, extractions, root canals, periodontics, and repairs to dentures, bridges, and crowns
20% coinsurance after deductible
20% coinsurance after deductible
Major Restorative Care such as dentures, bridges, crowns, and implants
40% coinsurance after deductible
40% coinsurance after deductible
Othodontia
40% coinsurance after deductible

Lifetime maximum benefit (per person):** $1,000

40% coinsurance after deductible

Lifetime maximum benefit (per person):** $1,000

*Out-of-network benefits are based on the maximum reimbursable charge. You are responsible for amounts that exceed this amount.
**All plan deductibles and maximums (dollar and occurrence) cross-accumulate between in-network and out-of-network unless otherwise noted.

For additional details about covered services, including what the plan pays if you use an out-of-network provider or facility, exclusions, and limitations, visit HRConnect to view the Cigna Dental Plan Option 1 summary plan description (SPD).

If You Use an Out-of-Network Dentist

  • You may pay more for services because non-participating dentists have not negotiated fee discounts with Cigna.
  • You may need to pay the dentist yourself and then submit a claim to be reimbursed by Cigna.
  • If you need to submit a dental claim yourself, ask your dentist for a standard American Dental Association claim form.

Connect with…

HRConnect
Monday–Friday,
7:30 a.m. to 5 p.m. ET
844-543-2147
203-200-3838 (fax)
Website
Choose the YNHH_PRD option

Cigna Dental Plan
800-244-6224
Website

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