What you pay for services.

Cigna Dental Care (DHMO) Plan DPPO Plan



$50 (individual)
$150 (family)

Calendar-year maximum

No maximum

$1,500 per person (what the plan pays)

Preventive and diagnostic (Routine cleaning, X-rays, oral exams, topical fluoride)



Basic restorative care (e.g., fillings)

The DHMO sets the cost for services based on a Patient Charge Schedule (PCS). The PCS is a list of fees for each covered service within the plan. Click here to see the full list of the costs.

20% after deductible

Major restorative care (e.g., crowns, bridges)

50% after deductible

Surgical implants

50% after deductible

Orthodontia coverage

50% after deductible

Note: In the DPPO, orthodontia coverage is available for children up to and including age 18, with a lifetime maximum of $1,500. In the DHMO, orthodontia coverage is available for adults and children.

Cigna Dental Care (DHMO) Plan Participants:

Check out the Patient Charge Schedule (PCS) to learn what amount you pay for covered services and any frequency limitations.