Open enrollment for insurance plans usually starts in October. We’d like to provide our patients with some information about what to ask when looking at dental benefits. A key thing to remember is that dental insurance is not really insurance; it is a benefit. Dental benefits define how much will be covered UP TO a certain amount, regardless of the dental services rendered. Here are a few questions to ask your Human Resources (HR) Department or the insurance companies you are looking at.

Please know that we participate in the Cigna DPPO Total Network, and Grid+ Network.

1. Can I go to any dentist I choose?

2. Can I go to an out-of-network dentist and still have my services covered?

3. How much will this plan pay for the following codes, and does the deductible apply?

D0150=Comp exam
D0120=Periodic exam
D1110=Adult prophy
D1120=Child prophy (to age 14)
D0274=4 X-rays
D0220=Periapical X-ray
D2740=Porcelain crown
D2740=Porcelain crown
D7140=Extraction
D7210=Surgical extraction
D2160=3 surface amalgam filling
D2332=3 surface composite filling

4. Are exams and cleanings covered twice per year (less than 6 months apart) or once per 6 months?

5. How often are X-rays covered?

For Cigna Plans:

6. Does my employer have their own fee schedule or is payment based on the doctor’s contracted in-network fee schedule?

7. Can I go to any Cigna DPPO Total provider, or am I limited to certain ones?