CIGNA Dental Important Announcement:
HR received several emails from you indicating Today’s Dentistry in Wisconsin is no longer going to be an in network dentist as of July 1. They have elected to leave the network therefore, we encourage you to find an in network dentist for services after July 1.
How do I find if my dentist is in network, or find a different dentist?
If you login to your CIGNA account, https://my.cigna.com/web/public/guest, and search for dentists you will find quite a few in network dentists. It also tells you how any co-workers see that dentist.
How do I get an insurance card?
The Human Resources department has the generic cards available for you to pick up. The members name and number would be your name and your social security number for them to look up coverage.
Why is network important when my dentist processes through insurance either way?
You maximize your dental insurance benefit when you use a dentist who is in network. Prices are negotiated and dentists in network are limited to what can be charged for services. Preventative care is covered at 100% and you will receive no bill. Basic care is covered at 80%. Major care is covered at 50%.
If you go out of network, the dentists can charge any rate and Cigna will only pay a portion of what is “reasonable and customary.” “Reasonable and customary” is determined by CIGNA, varies by geographic location and service provided. It is NOT necessarily what they negotiate in-network.
- Preventative care drops from 100% coverage to 80% of “reasonable and customary” charges. For example(note: not actual figures), if it is “reasonable and customary” for dentists in Ozaukee County to charge $100 for a cleaning, Cigna will pay 80%-or $80. If your out-of-network dentist charges $80 you would not see a bill. If your out-of-network dentist charges $150, you would receive a $70 bill.
- Basic care drops from 80% coverage to “80% of 80% of reasonable and customary.” (EXP: If R&C is $300 for a tooth extraction, and your out-of-network dentist charges $300, Cigna will pay $192 and you will pay $108. However if that out-of-network dentist charges $500, Cigna will still only pay $192.)
- Major care drops from 50% coverage to $0. Not only will you receive the entire bill, but you also do not have the protection of negotiated rates of the network. Whatever the dentist charges will be your responsibility in full.
If I choose to go out-of-network, is dental insurance still beneficial?
You still do receive a benefit, it’s just not nearly as much as if you utilize someone in network. Ultimately, you have to decide if the benefit derived exceeds the premium paid.
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