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    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.

    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.