Cigna Preferred Dentists
Cigna Dentists in Plantation
Cigna Preferred Provider Organizations (PPOs) offer a wide selection of dentists to their clients. A PPO patient can choose a dentist from a list of dental providers that have contracts with Dental insurance to provide services. If you choose a dentist, you receive benefits available under the policy.
Does Cigna dental cover Implants
As of 2017 plans with surgical implant coverage are available .
Prior authorization may be required for certain specialty care treatments like dental implants. Only those procedures that are medically necessary and listed on the plan’s Patient Charge Schedule (PCS) are covered.
Services related to the surgical placement of a dental implant are limited to one per year with replacement of a surgical implant frequency limitation of one every 10 years. Prosthesis over implant replacement is limited to every 5 years if unserviceable and cannot be repaired. The frequency limitations of certain other covered services are set forth in the PCS.
Composite filling or white filling
Are they covered under Cigna Dental?
Cigna Dental’s plans cover white fillings. However, some Cigna plans may restrict this benefit depending on the location of tooth. For more detailed information see Cigna plan booklet or contact our office.
Are there any restrictions in replacing my missing teeth with Cigna Dental?
The "Tooth Missing But Not Replaced” rule applies to initial dentures, fixed and removable bridgework and implants that replace teeth missing, lost, or extracted before the effective date of coverage. Services subject to the "Tooth Missing But Not Replaced" rule may not be covered by your Cigna Dental plan. See Cigna Dental plan booklet or call our office for specifics.
Orthodontia - Braces.
Which orthodontia treatments are covered under Cigna Dental?
Cigna Dental PPO plans may cover comprehensive orthodontic -braces treatment of transitional, adolescent and adult teeth. See Cigna Dental plan booklet or call our office for specifics.
Dentures and partials replacement rule
How often will my plan replace dentures and partials?
These plans do cover replacement dentures and partials, subject to plan limitations or exclusions. See your Cigna plan document or contact us for details.
Services started before your Cigna Dental Insurance effective date
What will the Cigna Dental plan cover if a service started before my effective date?
- If you were covered under a previous insurance carrier and started dental treatment for the following services while you were still eligible under that plan, the extension of benefits provision under your earlier plan should consider the service:
- crowns and fixed bridgework when the teeth were prepared before the effective date of this plan
- appliances, when the impression was taken before the effective date of this plan
- root canal therapy, when the tooth pulp chamber was opened before the effective date of this plan
- If you were not covered under a previous carrier and started treatment for a service, it may not be considered eligible under this plan if your plan has a work-in-progress exclusion.
If more than one dental service is needed to fix a problem, most services would be considered separately. Although dental services started before the start date of coverage may be denied, any dental services started after the effective date would be considered for benefits.
Cigna Dental Frequency limitations
Are there restrictions to how often a dental service can be performed?
Yes, there are certain services that will have a frequency limitation. As an example, standard plans include frequency limitations for the following dental procedures:
- Cleanings – 2 per calendar year
- Exams – Routine: 2 per year. Problem focused: 2 per year
- Fluoride treatment – 1 per year for children under age 16
- Bitewing X-rays – one set per calendar year
- Full mouth X-rays – one set every 3 rolling years
- Sealants – 1 per tooth every 3 rolling years under age 16; permanent molars only
- Scaling and root planing (deep cleaning) – 4 separate quadrants every 2 rolling years
- Periodontal maintenance – 2 per calendar year following active therapy
- Gingivectomy – 1 per quadrant or site every 3 rolling years
- Periodontal Osseous surgery - 1 per quadrant every 3 rolling years
- Space maintainers – no age limit (covered for premature loss of primary teeth only)
- Denture and crown replacement – must be at least 8 years old
- Dental implant - coverage varies - call for detail
Please see your Cigna plan document or call our office for details.
How will I know if the dental treatment I need will be covered by Cigna?
The easiest way is to have your dentist send a pretreatment estimate (predetermination).
This will let both you and the dentist know what the benefit would be if the service were done.
Your dentist may also call customer service at the number on your ID card for general information about your dental coverage.
Wisdom teeth extraction and regular extraction.
How will tooth extraction services be covered by my Cigna dental plan?
Extractions maybe consider under your Cigna medical or Cigna dental plan. Please send Cigna a predetermination.
For more information on simple and surgical extractions please call our office.
When is periodontal maintenance covered by Cigna?
This procedure is for patients who have previously been treated for periodontal disease. Cigna PPO plans require surgical and/or nonsurgical periodontal history.
Invisalign | Orthodontic - Braces takeover and work-in-progress
Continuing or starting braces treatment – What do I need to know?
If you or an eligible family member is enrolled in active braces treatment or considering treatment, Cigna dental want you and your orthodontist to have a positive experience when you transition your braces treatment.
Please include all of the following information with your first paper or electronic claims submission. This will help Cigna make a benefit determination quickly and should eliminate the need for additional claims submissions.
- Banding date
- Number of months of treatment
- Assignment information
- ADA code
- Total case fee
- Primary insurance provides explanation of benefits (if coordination of benefits is necessary)
- Previous insurance provider information, including deductible, coinsurance/copay, maximum and amount paid to date (if patient is continuing active treatment). This will help determine your available orthodontic -braces benefit.
Please note that you do not have to change your orthodontist if you began braces treatment before your Cigna effective date. For member eligibility questions, call the Cigna Customer Service number on the member’s ID card.
Braces take over and work in progress
What is this and how will it impact my braces benefits?
Work in progress: This is a situation in which an individual member who was not previously active with the plan sponsor begins coverage with Cigna plan.
Example: Plan X sponsor has Cigna dental coverage effective 01/01/2013. A new X employee enrolls for dental coverage on 06/01/2015.
If your Cigna plan includes the work-in-progress exclusion, braces treatment will not be eligible for coverage. Please see your plan document or contact our office for details.
Takeover: This means a situation in which a plan sponsor previously had dental coverage through another carrier and provided coverage for the service. The plan sponsor terminates coverage with the previous carrier and begins coverage with Cigna. This only includes individuals who were covered under the prior plan at the time of the takeover.
Example: Plan sponsor X has YNZ dental coverage effective 01/01/2009. The entire X Company terminates with XNZ dental on 12/31/2010 and begins coverage with Cigna dental on 01/01/2010.
In orthodontic takeover situations, the treatment is only eligible for consideration under Cigna if the previous dental carrier covered and considered the member’s braces treatment plan.
Plantation & Fort Lauderdale | Broward County
What can I do once I am enrolled in Cigna dental plan?
Our office provides family, cosmetic and implant dental service for the cities of Fort Lauderdale, Davie, Pembroke Pines, Hollywood, cooper City Find a dentist.
Track a claim. Replace your ID card and more. It’s easy with our Cigna secure member website that is available 24 hours a day, 7 days a week. You can:
- Find a network dentist on their online directory. Search for a dentist by name, specialty, zip code like 33324. You can do it by city and state, or county and state. You’ll even find maps and directions to your dentist’s office.
- Get estimated average costs for cleanings, fillings, X-rays, dentures and more.
- See who’s covered by your Cigna plan.
- Check Cigna dental claims and statements.
- Send Cigna Customer service an e-mail.
BOOK your dental appointment ONLINE! Appointment Request
Cigna Dental resources: www.Cigna.com