Dental Plans Overview
Pearson offers dental coverage through Delta Dental and Cigna DHMO. Both are designed to help you maintain a healthy smile through regular preventive care and to fix any problems as soon as they occur.
Delta Dental of MN PPO
As a member enrolled in the PPO plan administered by Delta, you have access to two Delta networks: the Delta PPO network and the Delta Premier network. The difference in networks is the size. If you choose a provider in the smaller Delta PPO network, you will pay less out of pocket. If you use the larger Delta Premier network, you will have slightly higher costs. Regardless of which network you choose, if you use a non-network provider, your reimbursement will be based on reasonable and customary limits.
Cigna DHMO
The Cigna dental plan is a DHMO (Dental Health Maintenance Organization). It offers NO annual maximums, deductibles, reasonable and customary limits, or claim forms to file. Copayments vary based on the service and you must use a participating dentist in order to be covered. Cigna is only available in some areas. See the Schedule of Services for the DHMO (Cigna Dental Care Network).
Note: If you currently live in Puerto Rico, your dental coverage will be provided by Triple-S.
For cost details, visit Aptia365.
| Delta Dental PPO (In-Network – Premier or PPO) | Delta Dental PPO (In-Network -Premier or PPO) | Cigna DHMO (In-Network Only) | |
|---|---|---|---|
| Deductible (Individual/Family) | $50/$150 | $50/$100 | $0/$0 |
| Preventative Services | 100% | 100% | 100% |
| Basic Services | 80% | 80% | Copays vary by service |
| Major Services | 50% | 50% | Copays vary by service |
| Annual Benefit Maximum | $2,000 | $2,000 | N/A |
| Orthodontia (Adults and Children) | 50% | 50% | Copays vary by service |
| Orthodontia (Lifetime Maximum) | $2,500 | $2,500 | Copays vary by service |
Use Your Dental Benefits Wisely
Here’s how to make the most of your dental benefits:
- Choose a provider: Using a participating dentist in the Delta Dental network will ensure you receive the highest benefits from your plan. To find a provider, go to Delta Dental. You must use a network dentist if you choose the Cigna DHMO. Non-network dental care is not covered under the Cigna DHMO
- If your service will exceed $300, submit for a pre-treatment estimate. You should always submit a request for a pre-treatment estimate for procedures and services your dentist believes will exceed $300 (procedures such as crowns, inlays, bridges, and periodontics). For more information, call 1-855-237-6421 or visit the Delta Dental or Cigna DHMO website
- Check your claim status and other information at Delta Dental or Cigna DHMO. You can review Explanation of Benefits (EOB) statements, check if claims have been paid, and more.