How Does Cigna Dental Insurance Work?
Dental Insurance
Dental insurance helps lower the cost associated with dental care and reduces the amount patients pay on their own for services. Below is a summary of how dental insurance works and common terms used to explain insurance coverage.
Premium
The premium is a monthly fee that patients pay for their dental insurance coverage. When patients receive dental insurance through an employer, it is often deducted directly from their paycheck. Patients who purchase their own plan will pay the monthly premium directly to the insurer such as Cigna or another provider.
Primary Dentist
In some cases, certain types of dental insurance require that patients select a primary dentist. A primary dentist is your regular dentist who you see for routine visits and any issues. The dentist will also coordinate or refer patients to a specialist if needed.
Waiting Period
Some plans include a waiting period. The waiting period is a set amount of time that patients have to wait for dental care coverage beyond preventive care.
Network
Some plans differentiate coverage based on whether the dentist is in or out-of-network. The plan may limit coverage for dental care provided by dentists within the network. Patients will incur higher costs for care obtained by dentists outside of the network.
Deductible
Dental insurance can also come with deductibles. A deductible is the amount of money patients are required to pay out-of-pocket for dental care. Once the deductible is met, the plan begins to share the cost for dental services.
Coinsurance
Coinsurance kicks in once patients meet their deductible. This means the provider will begin sharing a set percentage of the costs associated with dental care. Some dental insurance plans may also have a set annual maximum. The annual maximum is the most the plan will pay for dental care obtained within the year. After meeting the annual maximum, patients must pay for any additional costs.
Copay
The dental insurance plan may require patients to pay a certain amount for dental care. This is typically a pre-set amount that patients are responsible for.
Preventative Care
Many dental insurance plans cover the cost for preventive dental care. This often includes things such as an oral examination, professional cleaning, and certain types of x-rays. The frequency of preventive care is often every six months but may vary. Pediatric patients may have additional care included within their preventive care coverage.
Restrictions
It is important for patients to be aware of any restrictions associated with frequency or limitations. The coverage will dictate what services are and are not covered. Most patients are able to receive a dental exam and cleaning every 6 months at no cost. There may be other restrictions associated with the type of dental care and frequency of treatment.
Dental Insurance Coverage
In many cases, employers will offer dental insurance coverage as part of the employee’s benefits. Patients can typically apply for coverage during the open enrollment period.
Patients who do not have dental insurance through an employer or those who are self-employed can purchase their own dental insurance plan. This can be done directly through a health insurance company such as Cigna, or through another provider. Dental insurance coverage can also be obtained through a state health exchange.
Call our office to discuss the services we offer and discuss any questions regarding your dental insurance.