Both Cigna PPO plans allow participants to choose any provider they wish and receive benefits. The covered benefits listed below apply to both in-network and out-of-network dental care for each plan. However, you generally pay less when you go to network dentist because dentists in the network have agreed to charge discounted fees.
|CIGNA DENTAL PPO||CIGNA DENTAL PPO PLUS|
|Cleanings Per Year||4||4|
(Deductible waived for preventive services)
|Annual Maximum Benefit per member (progressive maximum)||Year 1: $1,000
Year 2: $1,100
Year 3: $1,200
Year 4: $1,300
|Year 1: $2,000
Year 2: $2,100
Year 3: $2,200
Year 4: $2,300
|Preventive/Type A Coinsurance (cleanings)||100% covered||100% covered|
|Basic/Type B Coinsurance (fillings)||80% covered||80% covered|
|Major/Type C Coinsurance (crowns, dentures)||50% covered||50% covered|
|Orthodontia/Type D Coinsurance*||N/A||50%|
|Orthodontics Lifetime Maximum*
(child and adult)
|Reimburse % UCR||90th Percentile||90th Percentile|
* Starting Jan. 1, 2024, orthodontia benefits will change to:
- Dental PPO plan will add coverage for orthodontia services for dependents up to age 18 only, up to a lifetime maximum of $1,000 per covered participant.
- Dental PPO Plus plan will be available to adults AND dependents up to age 18 and the lifetime maximum is increasing to $2,000 per covered participant.