All eligible Coke Northeast employees who work at least 30 hours per week are offered a dental plan through Cigna. When you are enrolled in one of the medical plans, you are automatically enrolled in the dental plan at no additional cost.
Plan Details
| Benefit | In-Network | Out-of-Network |
|---|---|---|
| Calendar Year Deductible Individual Family | $60 $120 | $60 $120 |
| Calendar Year Maximum | $1,500 | $1,500 |
| Class I - Diagnostic & Preventative (Bitewing X-Rays, Full Mouth X-Rays, Cleaning, Oral Exams, Sealants) | No Charge | No Charge |
| Class II - Basic Restorative (Fillings, Scaling & Root Planning, Simple Extraction) | 10% after Deductible | 10% after Deductible |
| Class III - Major Restorative (General Anesthesia, Dentures, Single Crowns) | 40% after Deductible | 40% after Deductible |
| Class IV - Orthodontia | 40% after Deductible | 40% after Deductible |
| Class IX- Implants | 40% after Deductible | 40% after Deductible |
**For services provided by a non-network dentist, Cigna Dental will reimburse according to the Maximum Reimbursable Charge. The MRC is calculated at the 90th percentile of all provider charges in the geographic area. The dentist may balance bill up to their usual fees.
Cigna Dental Oral Health Integration Program
Get the dental services you need for your medical condition. Enroll in the Cigna Dental Oral Health Integration Program today.
What is the Cigna Dental Oral Health Integration Program?
It’s a program that reimburses out-of-pocket costs for specific dental services used to treat gum disease and tooth decay. The program is for people with certain medical conditions that have been found to be associated with gum disease and cavities. There’s no additional cost for the program – if you qualify, you get reimbursed!
Do I Qualify?
If you have a Cigna dental plan, you’re eligible for the program. You do NOT have to be enrolled in a Cigna medical plan to be eligible for this program. You must currently be under treatment by a doctor for any of the following conditions:
- Heart disease;
- Stroke;
- Diabetes;
- Maternity;
- Chronic kidney disease;
- Organ transplants;
- Head and neck cancer radiation.
How does it work?
When you visit your dentist, you will pay your usual out-of-pocket costs (deductible, copay or coinsurance amount). As a reminder, your copay is the fixed amount you pay for covered services, and your coinsurance is the percentage of costs you pay for covered services. Next, your dentist will send Cigna a claim. We review the claim and will refund your out-of-pocket costs for eligible dental services. Once we receive your claim, you can expect to be reimbursed in about 30 days. You must enroll in this program prior to receiving treatment to be eligible for reimbursement.
What else does the Oral Health Integration Program Include?
When you join the program, you get discounts on prescribed mouthwashes, fluoride gels, and toothpastes from your dentist through Cigna Home Delivery Pharmacy who will help you get these items sent right to your home.
You can ask us for information on the issues that affect your oral health and your overall wellness – such as fear of going to the dentist, or the impact of stress or tobacco products. We’ll also give you guidance on how to overcome these behaviors.
What dental services are covered under the Cigna Dental Oral Health Integration Program?
Check out the chart below to see which dental services are covered for each qualifying medical condition.
| Dental Services | Heart Disease | Stroke | Diabetes | Maternity | Chronic Kidney Disease | Organ Transplants | Head and Neck Cancer Radiation |
|---|---|---|---|---|---|---|---|
| Periodontal Treatment & Maintenance (D4341, D4342, D4910(2)) | Y | Y | Y | Y | Y | Y | Y |
| Periodontal Evaluation (D0180) | Y | ||||||
| Oral Evaluation (D0120(3), D0140(3), D0150(3)) | Y | ||||||
| Cleaning (D1110(4)) | Y | ||||||
| Scaling in the presence of inflammation - Full Mouth (D4346(4)) | Y | ||||||
| Emergency Palliative Treatment (D9110(5)) | Y | ||||||
| Topical application of fluoride & Topical application of fluoride varnish (D1206(6)) | Y | Y | Y | ||||
| Topical application of fluoride - excluding varnish (D1208(6)) | Y | Y | Y | ||||
| Sealants (D1351(6)) | Y | Y | Y | ||||
| Sealant Repair - per tooth (D1353(6)) | Y | Y | Y | ||||
| 1. Eligibility, reimbursement and coverage for eligible services are subject to plan year maximums. 2. Four times per year subject to plan guidelines. 3. One additional evaluation. | 4. One additional cleaning. 5. No limitations. 6. Age limits removed, all other limitations (including frequency limitations) apply. |
||||||
What are Periodontal Treatment and Maintenance?
Periodontal treatment and maintenance are not the same as prophylaxis or “regular cleaning.” Periodontal treatment (or “scaling and root planning”) consists of “deep cleaning” which involves parts of your teeth below the “gum line.” During scaling and root planning the dentist may numb the area of your mouth that she/he is working on. Periodontal maintenance is a follow-up procedure involving removal of plaque and calculus (tartar) above and below the gum line along with scaling and root planning in areas where needed.
How do I enroll?
- You must fill out the online registration form found on myCigna.com. You can also call the number on the back of your ID card to have an enrollment form sent to you. You only need to complete the form one time per qualifying condition.
- Once you’re logged in on myCigna.com, click “Review my Coverage” then select “Dental” from the drop down menu. Next, from the “Related Links” section on the right side of the page, select “Cigna Dental Oral Health Integration Program Registration Form.” Fill out the form and click “Submit.”
- Visit your dentist and pay your usual out-of-pocket cost for the covered service. We’ll send your reimbursement.
To learn more call Cigna 24/7/365 at 800-Cigna24.