Dental Plan Options
Cigna Dental PPO Low Option + Cigna Dental PPO High Option MAA offers two dental plan options through Cigna. Both plans give you the flexibility to receive care in or outside of Cigna’s DPPO Network. However, when you receive care in-network, your costs are lower. Those who need less care can pay less by choosing the Low Option, while those who need more care, including Orthodontia, can choose the High Option. 2023 Bi-Weekly Associate Payroll Contributions by Dental Plan Option & Coverage Level Dental PPO Low Option Dental Plan High Option Employee Only $9.61 $13.51 Employee + Spouse $20.20 $28.38 Employee + Child(ren) $17.31 $29.72 Employee + Family $23.08 $40.54
Cigna Dental PPO Low Option Cigna Dental PPO High Option
Benefit
In-Network
Out-of-Network
In-Network
Out-of-Network
General Plan Information Reimbursement Levels Calendar Year Deductible Individual Family Calendar Year Benefits Maximum Benefit Highlights Class I: Diagnostic & Preventive Oral Exams, Cleanings, X-rays, Fluoride Application & Sealants Class II: Basic Restorative Fillings, Periodontics, Oral Surgery, Bridge Repairs, Crowns & Dentures Class III: Major Restorative Inlays/Onlays, Prosthesis, Over Implant, Crown, Bridges, Dentures Class IV: Orthodontia Coverage for Adults & Children, Lifetime Benefits Maximum: $2,500
Maximum Reimbursable Charge (MRC)
Maximum Reimbursable Charge (MRC)
Based on Contracted Fees
Based on Contracted Fees
$50 $150
$50 $150
$50 $150
$50 $150
$1,500 per person Applies to Class I, II, III expenses
$1,500 per person Applies to Class I, II, III expenses
$2,500 per person Applies to Class I, II, III, IX expenses
$2,500 per person Applies to Class I, II, III, IX expenses
Plan pays 100% of MRC
Plan pays 100% of MRC
Plan pays 100%
Plan pays 100%
After Deductible Plan pays 80% You pay 20% After Deductible Plan pays 50% You pay 50%
After Deductible Plan pays 80% of MRC You pay remainder After Deductible Plan pays 50% of MRC You pay remainder
After Deductible Plan pays 80% You pay 20% After Deductible Plan pays 60% You pay 40% No Deductible, Plan pays 50% up to Lifetime Benefits Maximum After Deductible Plan pays 50% You pay 50%
After Deductible Plan pays 80% of MRC You pay remainder After Deductible Plan pays 60% of MRC You pay remainder No Deductible, Plan pays 50% up to Lifetime Benefits Maximum After Deductible Plan pays 50% You pay remainder
Not Covered
Class IX: Implants
Not Covered
Click here for the benefit summary for the Cigna PPO Low Option. Click here for the benefit summary for the Cigna PPO High Option.
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