Dental Benefits

As an employer, you may offer any of three Cigna dental plans if you participate in the Medical Trust health plans.

All plans cover preventive care and three dental cleanings a year at no cost to members when network providers are used. Cigna offers a choice of providers in their dental network of dentists, endodontists, pediatric dentists, periodontists, orthodontists, and other dental providers.

  Preventive Dental PPO Plan Basic Dental PPO Plan Dental & Orthodontia Plan
  DPPO Advantage DPPO and Out-of-Network DPPO Advantage DPPO and Out-of-Network DPPO Advantage DPPO and Out-of-Network
Deductible $0 person / $0 Per Family $0 person / $0 Per Family $0 person / $0 Per Family $50 per person / $150 Per Family $0 person / $0 Per Family $25 per person / $75 Per Family
Annual Benefit Limit $1,500 per person $2,000 per person $2,000 per person
Preventive and Diagnostic Services You pay $0 (not subject to annual deductible) You pay $0 (not subject to annual deductible) You pay $0 (not subject to annual deductible)
Basic Restorative Services You pay 20% coinsurance You pay 15% coinsurance You pay 15% coinsurance after deductible You pay 15% coinsurance You pay 15% coinsurance after deductible
Major Restorative Services You pay %99 coinsurance You pay 50% coinsurance You pay 50% coinsurance after deductible You pay 15% coinsurance You pay 15% coinsurance after deductible
Orthodontia Services Not covered. You pay 100% Not covered. You pay 100% You pay 50% coinsurance up to individual lifetime benefit limit of $1,500 You pay 50% coinsurance up to individual lifetime benefit limit of $1,500 after deductible

Please note: Preventive procedures are not subject to the annual out-of-pocket limit.

For information about the Dental Plans for 2023, see the plan Summaries of Benefits and Coverage:

For detailed descriptions of our three dental plans, download our Cigna Dental Handbook.

 

The Episcopal Church Medical Trust Disclaimer

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