Page 9 - Rampart EE Guide 01-19 (flipbook)

BENEFITS

DENTAL INSURANCE

Cigna | Advantage PPO Dental Plan
With the Cigna Advantage Preferred Provider Organization (PPO) dental plan, you may visit an Advantage PPO dentist and benefit
from the negotiated rate or visit a non‐network dentist. When you utilize an Advantage PPO dentist, your out-of-pocket expenses
will be less. You may also obtain services using a non-network dentist; however, you will be responsible for the difference between
the covered amount and the actual charges and you may be responsible for filing claims.

Cigna
Plan Name ADVANTAGE PPO
Network Name Cigna ADVANTAGE PPO Network Cigna DPPO & Non-Network
Dental Benefits Reimbursement based on maximum
allowable charge
Deductible (Annual)
- Individual $50 $50
- Family $150 $150

Calendar Year Maximum $1,500 Reimbursement from Cigna is based on
“allowed charges” which means Cigna
Preventive (Plan Pays) 100% sets a cap on how much they will
Exams, X-Rays, Cleanings reimburse a Cigna DPPO or a
Basic Services (Plan Pays) Deductible, 80% Non-Network dentist. You will be
Fillings, Oral Surgery, Endodontics, Periodontics responsible for any charges in excess of
Major Services (Plan Pays) Deductible, 50% this cap. This will result in a much higher
Crowns, Prosthetics level of out of pocket costs to you
Orthodontia
- Covered Members Children & Adults
- Coinsurance 50%
- Lifetime Benefit Maximum $1,500

Finding a Dental Provider
Go to MyCigna.com or if not enrolled, www.cigna.com and click on “Find a Doctor”. Click on the “Plans
through your Employer” or call (800) 244-6224. Click on the Cigna DPPO Advantage/Cigna DPPO network
when prompted. IMPORTANT: ADVANTAGE dentists are In-Network. If you choose a dentist coded like this:
you may be balanced billed as you would using an out-of-network dentist.

Tips for Using Your Dental Benefits

Understand your plan.

Understanding your dental plan’s benefits, including how copays, deductibles, and calendar year maximum benefits work, is
key to getting the most value from your plan and avoiding surprises.

Take advantage of preventive services offered by the plan.

The least expensive way to maintain good oral health is to go to your dentist at least twice each year for an exam and
cleaning. Regular dentist visits can help prevent serious health problems such as oral diseases and cancers, and going to the
dentist is more affordable in the long run for those who are insured and take advantage of every service.

Ask for a predetermination of benefits.

We recommend you ask your dentist for a predetermination if total charges are expected to exceed $300. Predetermination
enables you and your dentist to know in advance what the payment will be for any service that may be in question.
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