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What Is Covered

The plans pay for many of the preventive, basic and major services you and your family receive. The following services are covered under each plan:

Preventive Services

  • Routine oral exams every six months
  • Teeth cleaning every six months (including scaling and polishing for covered members age 14 and over)
  • Fluoride application for dependent children to age 18 once a year
  • Bitewing X-rays every six months
  • Full mouth series or panoramic X-rays once every three years

Basic Services

  • X-ray and pathology
  • Space maintainers
  • Non-surgical extractions
  • Oral surgery
  • General anesthetics in connection with covered dental services
  • Periodontics, endodontics, and root canals for impaired teeth only (excluding final restoration)
  • Restorative dentistry including fillings, pins, stainless steel crowns, denture repairs, adding teeth to partial dentures (that replace natural teeth), recementation, and repairs to bridges and crowns
  • Treatment of diseased periodontal structures
  • Endodontic treatment. This includes root canal therapy.
  • Injection of antibiotic drugs.
  • Repair or recementing of crowns, inlays, bridgework or dentures.
  • Relining of dentures

Major Services

  • Replacement of an existing removable denture or fixed bridgework by a new denture, or the adding of teeth to a partial removable denture*
  • Inlays, gold fillings or crowns. This includes precision attachments for dentures
  • First installation of fixed bridgework to replace one or more natural teeth extracted while the person is covered. This includes inlays and crowns as abutments
  • Replacement of an existing removable denture or fixed bridgework by new fixed bridgework, or the adding of teeth to existing bridgework*

* The following Prosthesis Replacement Rule must be met: (a) The replacement or addition of teeth is required to replace teeth extracted after denture or bridgework was installed (extraction must have been covered under Plan); (b) The denture or bridgework (must be 5 or more years old) cannot be made serviceable; (c) The denture must be an immediate temporary one to replace natural teeth extracted while you are covered and cannot be made permanent; and (d) Replacement by a permanent denture must be needed. Replacement must take place within 12 months from the date the immediate temporary one was first installed.

 

 
Dental
What Is Covered
What Is Not Covered
2024-2025 Dental Rates
Orthodontia
When Your Coverage Ends
Glossary of Dental Terms

Related Forms
form icon Dental Rates
form icon Cigna Dental Benefit Summary Option A
form icon Cigna Dental Benefit Summary Option B
form icon Cigna
form icon myCigna.com
   
Related Links
Cigna

    Important Legal Information:
Appoquinimink Benefits Online provides only an overview of your benefits from Appoquinimink School District and The State of Delaware. Appoquinimink School District and The State of Delaware reserve the right to amend or to terminate any benefit plan at any time, with or without notice. Review more important legal information about your benefits plans.

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