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Glossary of Dental Terms

The following explanations will help you understand how the dental plans work:

  • Annual Benefit Maximum
    For each calendar year (January 1 through December 31), each plan pays a maximum dollar amount toward your covered dental expenses. Once your dental benefits reach this dollar maximum, you are not eligible for dental benefits until the beginning of the next calendar year.

  • Copayment
    After the plan pays a percentage of the usual and customary fee for dental services, the remaining cost is your copayment. For example, if the plan pays 80% of a service, the remaining 20% is your copayment. Keep in mind, the actual charges may be greater than what the insurance company defines as a usual and customary charge. If so, you are responsible for payment of any amounts over the usual and customary limits.

  • Dentist
    For the purposes of these plans, a dentist must be licensed and acting within the scope of his/her profession. Any other doctor or professional providing dental services must also operate within the scope of services he/she is licensed to perform.

  • Usual and Customary
    The plans only pay benefits for charges that are within usual and customary limits. This is an amount generally charged for similar services within your geographic area. If the fee is higher than the usual and customary charge, you are responsible for the remaining percentage of the charge (your copayment), as well as the charges above the usual and customary limit.

 
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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