We are pleased to provide information about the Dental Health Maintenance Organization-Prepaid Provider plan. This plan offers a full range of benefits through a network of participating dentists. Cigna Healthcare is providing your DHMO benefit plan.1
Implant Coverage Benefit
Orthodontics Coverage For All
Teledentistry Benefit
You must select a network general dentist who will manage your overall dental care. Covered family members can choose their own network general dentists near home, work or school. You may choose a network pediatric dentist for children under the age of 13.* Pediatric dentists are considered specialists in the DHMO plan. If you need assistance in selecting a dentist, contact Cigna Healthcare at 800.997.1617.
You will pay the copay amount listed on your Patient Charge Schedule for covered dental services performed by your network dentist.
If you need more advanced care, you will be responsible for your copay and any related dental lab charges. Many dentists use dental labs to fabricate crowns, bridges and dentures. Dentists and labs set their own prices for lab work, so to avoid surprises, ask for an estimate before scheduling any major restorative work.
An office visit copay applies per patient, per office visit and is in addition to any other applicable patient charges. Please refer to the PCS. Visit Cigna.com/stateoftn and click on the dental plan tab to find a copy of the PCS.
If your network general dentist does not perform the specialty care procedure you need, he/she can direct you to a participating network specialist.
Procedures not listed on your PCS are not covered, and you are responsible for the dentist’s usual fees.
The American Dental Association may periodically change codes on dental procedures and names. The PCS is subject to annual changes accordingly.
Remember: If you seek covered services from a dentist who does not participate in the Cigna dental network for the state of Tennessee, your plan will not pay except in the case of an emergency, or as required by law.
If you are working for an agency participating in the State Group Dental Insurance Program or have retired and meet the eligibility for retiree dental, you may participate in the state of Tennessee voluntary dental program. You may request to enroll when you are first eligible, if you acquire new dependents, or if you lose other dental coverage. Participation in the state group health plan is not required, but you can only enroll eligible dependents in the dental program if you are enrolled in the dental program yourself. Once enrolled, coverage will continue until Dec. 31 of the enrollment year, subject to continued eligibility. You may request to cancel coverage for individual members if that person (1) loses eligibility, (2) becomes newly eligible for other dental coverage, or (3) there is no participating network general dentist within 25-mile radius of your home address. During the program’s Annual Enrollment period, you can make coverage changes for the beginning of the next calendar year.
* Subject to state regulatory approval
The DHMO plan for Partners for Health is not available in all states.
