Dental Plan
Website: www.cigna.com
Phone: 1-800-244-6224
The Traditional Dental Plan (Dental PPO) provides payment for the following covered services, subject to the plan maximums and limitations:
Class Schedule
| Class I | Diagnostic and Preventive (no more than two in any calendar year). | 100% of reasonable and customary charges |
|---|---|---|
| Class II | Basic Restorative, Endodontics, Periodontics, Maintenance of Prosthodontics and Oral Surgery | 80% of reasonable and customary charges |
| Class III | Major Restorative, Installation of Prosthodontics | 60% of reasonable and customary charges |
| Class IV | Orthodontics | 60% of reasonable and customary charges |
The maximum benefit, excluding Class IV Services, is $2,000 per person each year. The lifetime maximum for Class IV Services (orthodontics) is $1,000 per person. Each year, you will need to meet a deductible of $50 per person, or $150 for family. The deductible does not apply to Class I and Class IV Services. As an additional plan feature, if you use a dentist who is a member of the Preferred Provider Organization (PPO), charges for covered services will usually be discounted. This means your cost will usually be less than that associated with a dentist who is not a member of the PPO. Please remember that under the Traditional Dental Plan (Dental PPO), you may use any dentist you wish; use of the PPO feature is voluntary. Out-of-network claims submitted to CIGNA after 365 days from the date of service will be denied.
CIGNA PPO is MCG's dental plan carrier. Use the Total CIGNA DPPO network of participating providers to receive in-network benefits.
Get assistance navigating CIGNA's online PPO directory.
CIGNA Dental PPO Summary
CIGNA Dental PPO Summary (Texas residents only)
CIGNA Dental PPO Certificate of Plan Booklet
CIGNA Dental PPO Certificate of Plan Booklet (Texas residents Only)
Dental Claim Form
CIGNA Dental Mobile App
CIGNA Dental PPO Wellness Plus Maximum Rollover Program
CIGNA Dental Oral Health Integration Program
Smart Scan Flyer
Nominate Your Dentist
Transition of Care