Are Dental Implants Covered by Cigna Insurance? My Complete Guide

Table of Contents

• 3.1 PPO Plans
• 3.2 DHMO Plans
• 3.3 Employer, Individual, and Medicare Advantage
• 3.4 Core Limitations and Key Terms

• 4.1 Diagnostics
• 4.2 Surgery: Post, Abutment, and Crown
• 4.3 Ancillary Procedures: Bone Graft and Sinus Lift

Introduction: Why I Needed Answers About Cigna Dental Implant Coverage

When my dentist first talked about dental implants, my first thought was, “Will my Cigna dental insurance even help with this?” If you feel the same, you’re definitely not the only one. Dental implants can cost a lot. I spent hours looking at my plan details, calling Cigna, and learning from all the little problems along the way. My goal is simple: share what I found out, from figuring out Cigna coverage to ways to save money and avoid insurance surprises. I want you to finish reading and feel sure about your own dental health—and your wallet.

Does Cigna Really Cover Dental Implants? My Search for Straight Answers

Let’s keep it real, insurance talk is never simple. I wanted a straight yes or no. Instead, it was lots of details. So here’s what you actually need to know.

The Short Version

So, does Cigna cover dental implants? The quick answer: sometimes. Here’s what I learned.

• Cigna might pay for dental implants as a “major restorative service,” but almost never pays the whole thing.
• Your coverage depends on your plan: PPO, DHMO, through work, something you got yourself, or maybe Medicare Advantage.

If you thought insurance would pay everything, it’s pretty rare. You’ll probably pay some, but Cigna can help cut the price.

Medically Needed or Cosmetic

This part is important with Cigna. My claim had to show the implant was needed for health (like to help me chew or to keep my mouth healthy, not just because I wanted a nice smile). If the dentist’s paperwork said “cosmetic,” Cigna was going to say no. But if the dentist wrote about chewing troubles or jaw problems, I had a much better chance.

Why the Coverage is All Over the Place

I know two friends who both had implants, but Cigna covered us all differently. Why? Because:

• PPO and DHMO plans work in different ways
• Work insurance might have better coverage because employers add extra stuff
• Plans you buy yourself are often pickier and limit more
• Medicare Advantage plans with dental: Some pay for implants, a lot don’t

So always grab your plan details first. Guessing ended up costing me more money.

Cigna Plan Types: How Mine Affected My Coverage

How much Cigna helped came down to the plan I had. Here’s what happened in real life.

PPO Plans

This was my plan. PPO (Preferred Provider Organization) dental insurance gave me the most freedom.

• Usual coverage: Up to 50% of the “allowed amount” for big stuff like implants.
• Yearly maximum: Mine was $1,500—it sounds good, but one implant costs $3,000–$6,000 (for the post, abutment, and crown), so that benefit goes away fast.
• Deductible: $50 for each person. Cigna didn’t pay anything until I paid this.
• Waiting period: I had to wait 12 months before implant coverage kicked in.

One more thing: Cigna makes deals with in-network dentists to decide the “allowed amount.” If your dentist charges more, you have to pay the extra unless you use someone in-network.

DHMO Plans

I checked out DHMO (Dental Health Maintenance Organization) plans too. Here’s what I noticed:

• Cheaper every month, but barely any implant coverage.
• Some DHMO plans just give a discount, not real coverage.
• You must use Cigna’s in-network dentists—no choice.

If you might need implants soon, read all the details. DHMOs can leave you paying the whole bill for big stuff.

Employer, Individual, and Medicare Advantage

My friend’s Cigna through work was actually better than what I bought by myself—higher yearly maximums, sometimes better implant rules, and good “in-network” discounts. If you have work insurance, start there.

Medicare Advantage plans that come with Cigna dental? Some help with implants, most don’t. Always call and check.

Core Limits and Words to Know

Here’s how the important stuff worked out for me:

• Annual Maximums: This is the most Cigna will pay all year. When I hit it, everything else was on me.
• Deductible: I had to pay $50 before Cigna paid.
• Copayment: DHMOs have set fees for services; my PPO just used a percentage.
• Waiting Period: I had to have the plan for over a year before implants were covered.
• Missing Tooth Clause: Cigna wouldn’t pay for an implant if the tooth was gone before my policy started. Check for this in your plan.

Don’t want bad surprises? Highlight these things in your policy booklet.

What Parts of the Implant Process Did Cigna Cover for Me?

Most people (me included before) think an implant is just one thing. It’s actually a few steps. Here’s how Cigna treated it:

Diagnostics

• X-rays and Checkups: My plan paid pretty well for these, about 80–100%. This covered all the X-rays, scans, and the first exam.
• Pre-Implant Checks: Sometimes counted as “major services,” sometimes not—it depends, so ask your dentist how they’ll bill it.

Surgery: Post, Abutment, and Crown

• Implant Post (putting in the screw): Cigna called this a “major” service. My PPO paid 50% after I paid the deductible.
• Abutment (the middle piece): This connects the crown to the post. Same rule—Cigna paid 50%.
• Crown (the tooth looking part on top): Also 50%. But here’s the thing—each part counted toward my yearly max, so I had to plan out my timing since one implant could use up the whole benefit for a year.

Extra Procedures: Bone Graft and Sinus Lift

• Bone Graft: Sometimes Cigna covers this under dental, sometimes medical (if you’ve got a health reason). You must show paperwork for “why.”
• Sinus Lift: Same as above—mine was first denied, then they paid after my doctor sent more info.
• Tooth Removal: This was covered as a basic or major thing, not as much as X-rays.

Pro tip: Always ask what code your procedure will use. My dentist showed me each code, so I could check with Cigna before I signed anything.

How I Navigated Cigna’s Approval Process

This part is kind of boring, but it saved me a lot of trouble.

• Step 1: Ask for a Written Treatment Plan

My oral surgeon gave me a treatment plan that had all the procedures, codes, and a timeline. This helped me ask Cigna the right questions.

• Step 2: Submit for Pre-Authorization

My dental office sent this plan to Cigna to get it checked out first. Some plans require it, but I’d do it anyway—it’s good proof if there’s a problem later.

• Step 3: Review the EOB

About two weeks later, I got my “Explanation of Benefits” (EOB). It told me what Cigna would pay for, what they wouldn’t, and what was left for me.

• What If They Say No?

My bone graft got denied first. I fought back, sent more X-rays and a dentist letter saying why it was needed. After that, Cigna said yes.

Bottom line: Don’t be scared to check things or say something’s not right. Sometimes, asking again makes all the difference.

Maximizing My Benefits & Saving Money

Even with insurance, I saw the bills growing. Here’s what helped me not spend too much (maybe you can use these too):

• Use In-Network Dentists: Cigna PPO plans get lower fees with their own dentists. I picked one and saved lots.
• Spread Out Treatment Over Years: My yearly max was $1,500, so I did the implant post the first year and the crown the next year. That’s double the benefit.
• Have Medical Insurance Pay First for Some Things: My bone graft counted as “medically needed,” so my oral surgeon sent that part to my medical plan first.
• Financing/Payment Plans: For costs Cigna didn’t cover, I used CareCredit with 0% interest. I also asked the office if I could pay slowly or get a deal for paying cash.
• Dental Schools: If you like the idea, some dental schools can do implants for way less.

Here’s something maybe not everyone thinks of: I compared lab and materials with my dentist. Even though I didn’t get super detailed, implant dental laboratory quality actually made a difference in how long my implant lasted and how it fit. It’s okay to ask your dentist which dental lab they use and if that changes your price—sometimes it does.

How I Confirmed My Coverage, Step by Step

Don’t want to miss something? Here’s my checklist:

It’s boring but a must. I marked anything about big services, yearly limits, and things Cigna won’t pay for (like missing tooth rules).

Their online site showed my coverage, benefits, and let me get my full plan summary.

I had the codes ready, then asked them to go over what was covered for each one.

My office sent a “pre-treatment estimate” or “pre-determination” to Cigna. They gave this to me in writing, so I knew what to expect before they started.

Cigna and Dental Implant Costs: What I Paid

Here’s what happened in my case:

• Total price for one dental implant (post + abutment + crown): About $4,500
• What Cigna paid: $1,500 (hit my year max)
• What I paid myself: $3,000 (after my deductible)

But your costs will be different. Plan type, dentist, state, all these things matter. My advice: Use your plan’s numbers so you know your real costs before you schedule anything.

If you want to compare, get another opinion about the work and your coverage. Sometimes another dentist, or a crown and bridge lab, can show you different options or suggest something else that fits your insurance better.

My Tips: Making the Most of Your Cigna Dental Plan

• Don’t skip checking the missing tooth clause: If your tooth was gone before you had Cigna, they probably won’t pay.
• Always get pre-authorization: Get it on paper.
• Watch your annual max and deductible: Talk to your dentist and plan the work if you need more than one implant.
• Be honest with “medical need”: Don’t pretend it’s not cosmetic; real health reasons are needed for Cigna to agree.
• Ask about dental labs and what they use: Whether it’s a newer digital dental lab or a regular one, your dentist should tell you. Labs can change the cost and outcome.
• Ask about removable vs. fixed options: Sometimes, removable denture lab work is paid for more easily—worth asking about.

In Closing: Taking Charge of Your Dental Implant Journey

Looking back, what started as confusing insurance forms and cost worries ended up teaching me a lot about being patient and speaking up for myself. Dental implants are a big deal, and Cigna can really help, but only if you know what their rules are.

To sum up:

• Start with your own plan—read and ask before saying yes to any work
• Stay organized—treatment plans, codes, and written approvals are vital
• Don’t be scared to ask questions, fight denials, or appeal decisions
• Think about timing and price—smart planning can save a lot

With some effort (maybe a few long calls), you can work through the process and get your healthy smile without emptying your bank account. Good luck, and here’s to your health and your savings!