Dental HMO option: You choose a primary care dentist (PCD) in the Cigna network. Your PCD directs all your dental care and refers you to specialists as needed. All services have set copays based on a schedule of fees. There’s no deductible. The plan doesn’t cover expenses for services outside the Cigna Dental network except in emergencies, which require prior administrator approval. When you enroll in the Cigna Dental HMO, you agree to choose a PCD for you and your family. To select a PCD, call Cigna at 1-800-Cigna24 (1-800-244-6224)
Dental PPO option: You can go to any licensed dental provider. However, this option is a “silent PPO.” This means you have access to a preferred provider Cigna network. You receive the same level of coverage whether you use a provider that’s in or out of network. Using an in-network provider generally results in lower costs because these providers have agreed not to charge over the usual, customary and reasonable (UCR) limits. You may change dentists or seek care from a dental specialist at any time.
See the Providers page on the HISD Benefits for more information.
Yes, if you're a new enrollee in the Dental PPO plan, the missing tooth provision applies to you. That means the plan only pays 50% of the normal cost for replacing missing teeth until you've been a plan participant for 12 months. After 12 months, the service is considered a Class III expense.
Your assigned primary care dentist is responsible for completing a specialty referral form when you need specialty dental care.