Before you enroll, you can check to see if your dentist is in the Cigna Dental Care® DHMO network for the Partners for Health plan. Here’s how.
Enter your Address, City or Zip.
Select one of the three blue search category boxes to search by Doctor by Type, Doctor by Name or Health Facilities.
Note: Lab fees will be charged for certain procedures.
Referrals by your network general dentist are required for specialty care services except network pediatric dentists for children under age 13* and network orthodontists. The copays on your PCS also apply to covered network specialist care. If you go to a network specialist, there may be a different copay. Pediatric dentists are considered “specialists” for plan benefits.
Services for or in connection with an injury arising out of, or in the course of, any employment for wage or profit.
Charges which would not have been made in any facility, other than a hospital or a correctional institution owned or operated by the United States government or by a state or municipal government if the person had no insurance.
Expenses determined to be unlawful where the person resides when the expenses are incurred or the services are received.
Services for the charges which the person is not legally required to pay.
Charges which would not have been made if the person had no insurance.
Services due to injuries which are intentionally self-inflicted.
Services not listed on the PCS.
Services provided by a non-network dentist without Cigna Dental’s prior approval (except emergencies, as described in your plan documents).5
Services related to an injury or illness paid under workers’ compensation, occupational disease or similar laws.
Services provided or paid by or through a federal or state governmental agency or authority, political subdivision or a public program other than Medicaid.
Services required while serving in the armed forces of any country or international authority or relating to a declared or undeclared war or acts of war.
Services performed primarily for cosmetic reasons unless specifically listed on your PCS.
General anesthesia, sedation and nitrous oxide, unless specifically listed on your PCS.
Prescription medications.
Procedures, appliances or restorations if the main purpose is to: change vertical dimension (degree of separation of the jaw when teeth are in contact); or restore teeth which have been damaged by attrition, abrasion, erosion and/or abfraction; or restore the occlusion.
Replacement of fixed and/or removable appliances (including fixed and removable orthodontic appliances) that have been lost, stolen or damaged due to patient abuse, misuse or neglect.
Services considered to be unnecessary or experimental in nature or do not meet commonly accepted dental standards.
Procedures or appliances for minor tooth guidance or to control harmful habits.
Services and supplies received from a hospital.
The completion of crowns, bridges, dentures or root canal treatment already in progress on the effective date of your Cigna Dental coverage.4
Consultations and/or evaluations associated with services that are not covered.
Endodontic treatment and/or periodontal (gum tissue and supporting bone) surgery of teeth exhibiting a poor or hopeless periodontal prognosis.
Bone grafting and/or guided tissue regeneration when performed at the site of a tooth extraction unless specifically listed on your PCS.
Bone grafting and/or guided tissue regeneration when performed in conjunction with an apicoectomy or periradicular surgery.
Intentional root canal treatment in the absence of injury or disease to solely facilitate a restorative procedure.
Services performed by a prosthodontist.
Any localized delivery of antimicrobial agent procedures when more than eight of these procedures are reported on the same date of service.
Infection control and/or sterilization.
Services to correct congenital malformations, including the replacement of congenitally missing teeth.
The replacement of a night guard beyond one per any 24 consecutive month period, when this limitation is noted on the PCS.
Crowns, bridges and/or implant supported prosthesis used solely for splinting.
Resin bonded retainers and associated pontics.
Should any law require coverage for any particular service(s) noted above, the exclusion or limitation for that service(s) shall not apply.
