Compare the Costs

2022 Dental rates.

See how much you pay for Dental coverage, depending on the Option you choose, who you cover and the cost of covered services.

Crewmember (non-Pilots) Dental rate charts

Crewmember (non-Pilot) semi-monthly Dental rates.

Coverage:	DPPO	DHMO
Crewmember Only	$9.00	$3.75
Crewmember + Spouse	$17.00	$7.25
Crewmember + Child(ren)	$25.75	$11.25
Crewmember + Family	$33.25	$14.50

Crewmember (non-Pilot) weekly Dental rates.

Coverage:	DPPO	DHMO
Crewmember Only	$4.15	$1.73
Crewmember + Spouse	$7.85	$3.35
Crewmember + Child(ren)	$11.88	$5.19
Crewmember + Family	$15.35	$6.69

Pilot semi-monthly Dental rates.

Coverage	DPPO	DHMO
Crewmember Only	$7.00	$3.00
Crewmember + Spouse	$13.50	$6.00
Crewmember + Child(ren)	$20.50	$9.00
Crewmember + Family	$26.75	$11.50

Pilot weekly Dental rates.

Coverage:	DPPO	DHMO
Crewmember Only	$3.23	$1.38
Crewmember + Spouse	$6.23	$2.77
Crewmember + Child(ren)	$9.46	$4.15
Crewmember + Family	$12.35	$5.31

What you pay for services.

Service:	DPPO In- and out-of-network coverage (In-network shown below)	DHMO In-network coverage only
Primary care dentist	Not required	Required
Deductible	$50 (individual); $150 (family)	None
Preventive and diagnostic care	$0	$0
Basic restorative care	20% after deductible	The Cigna Dental Care Access Plus DHMO sets the cost of services based on the Patient Charge Schedule (PCS).The PCS is a list of fees and frequency limitations for each covered service within the Option. There is no calendar year maximum.
Major restorative care	50% after deductible
Orthodontia (varies by plan)	50% no deductible
Surgical implants	50% after deductible (in-and-out-of-network)
Calendar year maximum	$1,500 per person (including coverage for children age 18 and under)

Cigna Dental Care Access Plus DHMO participants.

Download the Patient Charge Schedule (PCS) to learn what amount you pay for covered services and any frequency limitations. If you’re enrolled in Cigna Dental Care Access, click here for instructions on selecting a Network Generalist Dentist.