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For eligibility, remaining balances, and coverage limits, please use CIGNA's Provider Portal or call the provider number on the back of the ID Card.
Current Status
Patient Name
Policyholder
Verification is not a guarantee of benefits or payment. Benefits are determined once the claim is received for processing.
Children age 18 and under do not impact the Family Max.
Effective Plan Year
thru
Amount Used Per Plan Year
Fam. Dental Annual Max ($2,000 Annual Max)
Lifetime
Ind. Orthotic Lifetime ($3,200 Lifetime Max)
Last Recorded Visit
Radiographs, Pan (Every 12 Months)
Radiographs, Com (Every 36 Months)
Periodic Oral Exam (Every 6 Months)
Radio 4 Bitewings (Every 6 Months)
Fluoride (Every 6 Months)
Sealants (Every 36 Months)
Cleaning Adult (Every 6 Months)
Cleaning Child (Every 6 Months)
Schedule of Benefits - Documents can be downloaded by clicking below.
picture_as_pdf Dental Schedule of Benefits
Benefit Infographs
Dental Infograph Orthodontia Infograph
Ind. Combined OOP
Fam. Combined OOP
Fam. Orthotic Limit
N/A
Physical Exam
Vision Exam
Lenses/Contacts
Heart Scan
Orthotic Visit
picture_as_pdf Medical Schedule of Benefits
Medical Infograph
Enter the policy holder SSN and patient birth date below to view current eligibility information.
The combination you have entered produced more than one possible patient. Please select the correct patient from the list below. To change patients, you will have to reenter their credentials on the search section and select the correct patient name.
Important! If you make an incorrect selection, you will have to go back and re-enter the patient info.
Enter parameters above to see patient eligibility and benefit summary.
Documents can be downloaded by clicking below.