Cigna Implant Coverage

Yes, on Cigna Dental PPO plans. Cigna typically reimburses implants as Major services at 50% of the allowed amount after deductible, up to your annual maximum (commonly $1,500). Cigna Dental Care DHMO plans are copay-based and may exclude implants entirely or apply flat fees. Cigna Dental Preventive plans cover preventive only, no implant coverage. Verify your specific 2026 plan at cigna.com. Lamb Family Dental files Cigna claims and submits pre-treatment estimates. Call (208) 344-6300 for a free benefits check.

Dr. Kimball Mack DMD & Dr. Kyle Pelletier DMD • Practicing in Boise since 2003 • 4.9★ on Google (491+ reviews) • Accepting new patients
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The 60-Second Answer

  • Q: Does Cigna cover implants? A: Yes on Cigna Dental PPO 1500 (50% Major). DHMO varies. Preventive plans pay $0 toward implants.
  • Q: How much does Cigna pay? A: 50% of the allowed amount up to annual max ($1,500 typical). On a $4,500 single-tooth case, expect Cigna to pay ~$1,500.
  • Q: Waiting period? A: 6–12 months on most new individual Cigna PPO plans for Major services. Group plans often waive.
  • Q: Cigna Dental Care DHMO, covers implants? A: Often excluded or at flat copay; varies plan-by-plan. Many Cigna DHMO plans don’t cover implants at all.
  • Q: ADA codes? A: D6010 (surgical placement), D6056 (prefab abutment), D6057 (custom abutment), D6065 (implant crown).
  • Q: Pre-treatment estimate? A: Strongly recommended. We submit photos, X-rays, CBCT, treatment plan to Cigna for binding written estimate.
  • Q: Is Lamb Family Dental in-network with Cigna? A: We accept Cigna Dental PPO and file claims. Verify in-network status during benefits check.

How Cigna Tiers Coverage

100%

Preventive

Cleanings, exams, X-rays, fluoride. Doesn’t count against annual max on most Cigna plans.

80%

Basic

Fillings, simple extractions, root canals, scaling. After deductible.

50%

Major (Implants Live Here)

Crowns, bridges, dentures, implants. 50% after deductible up to annual max ($1,500 typical).

Implant CDT codes: D6010, D6056, D6057, D6058, D6065. See ADA CDT.

Coverage details based on Cigna Dental 2026 plan documents. Three Cigna products (PPO, DHMO, Preventive) have different implant coverage rules, verify yours.

Will Cigna Cover My Implant? (Decision Tree)

flowchart TD A[Need a dental implant] --> B{Which Cigna plan?} B -->|Cigna Dental PPO 1500/2500| C[Major coverage at 50%] B -->|Cigna Dental Care DHMO| D{Plan-specific implant rider?} B -->|Cigna Dental Preventive| E[Plan pays $0 - no Major coverage] D -->|Yes - included| F[Flat copay schedule applies. Often $1,500-$2,500 patient cost.] D -->|No - excluded| G[Plan pays $0. Use cash/CareCredit/LFD savings.] C --> H{6-12 months on plan?} H -->|No - new enrollee| I{Waiting period waived?} I -->|No| J[Wait OR pay cash and submit later.] I -->|Yes| K{In-network at LFD?} H -->|Yes| K K -->|Yes| L[50% of allowed amount up to annual max $1,500] K -->|No| M[50% of allowed amount, you owe any balance over] L --> N{Annual max remaining?} N -->|Yes| O[Implant + abutment + crown each at 50%] N -->|No| P[Wait until plan year resets OR split across 2 years]

Implant Cost With vs Without Cigna in Boise

Cost of Single-Tooth Implant: Cash vs Cigna in Boise (2026)

Source: Healthcare Bluebook 83702/83704 + ADA Survey of Dental Fees 2024 + Cigna 2026 plan documents.

How Cigna Specifically Handles Dental Implants

1. Three Cigna products, three different implant rules

Per cigna.com 2026 plan documents:

  • Cigna Dental PPO 1500/2500: Implants are Major at 50% after deductible, up to annual max ($1,500 or $2,500 plan tier). Standard Major-services coverage.
  • Cigna Dental Care DHMO: Copay-based. Some plans include implants at flat fee schedule ($1,500–$2,500 patient cost). Many DHMO plans exclude implants entirely.
  • Cigna Dental Preventive: Preventive-only. Pays $0 toward implants.

2. Annual maximum and deductible

Cigna PPO 1500 has $1,500 annual max + $50 deductible. Cigna PPO 2500 has $2,500 annual max. The deductible applies once per benefit year on Basic/Major services.

3. Waiting period (6–12 months for new individual PPO plans)

Standard 6–12 month waiting period before Major services pay on new individual plans. Waiting period can be waived with documented 12 months of prior continuous dental coverage.

4. Pre-authorization / pre-treatment estimate

Cigna recommends pre-treatment estimates for any case over $1,500. We submit CBCT, photos, X-rays, treatment plan, and CDT codes. Cigna returns binding written estimate within 5–15 business days.

5. Implant placement billed in stages

D6010 (surgical placement), D6057 (custom abutment), D6065 (crown) each billed separately, each reimbursed at 50% Major. Total reaches annual max quickly on a single-tooth case.

6. Frequency and replacement limits

Cigna doesn’t typically include frequency limits on implants (since they last 25+ years). Replacement crowns on existing implants follow standard 5–10 year frequency.

7. Network status and allowed amount

In-network Cigna providers honor contracted fee schedules, lower allowed amount, lower co-insurance dollars. Out-of-network: Cigna pays 50% of “reasonable and customary” but you owe balance over.

Real Cost Example: Single-Tooth Implant on Cigna Dental PPO 1500

StageCDTAllowedCigna Pays (50%)You Pay
Surgical implant placementD6010$2,400$1,175$1,225
Custom abutmentD6057$700$325$375
Implant-supported crownD6065$1,400$0$1,400
Totals$4,500$1,500$3,000

Annual max ($1,500) hit after first two stages. Cigna pays $0 on the implant crown unless split across plan years.

How to Verify Your Specific Cigna Plan in 2 Minutes

  1. 1

    Let us verify it for you (fastest)

    Call (208) 344-6300 with Cigna member ID. We pull real-time benefits, confirm plan type (PPO/DHMO/Preventive), Major coverage, annual max, deductible, waiting period.

  2. 2

    Log in at cigna.com / mycigna.com

    Pull your “Schedule of Benefits” PDF. Search for “implant” and “Major services.”

  3. 3

    Call Cigna member services

    Have member ID + DOB ready. Ask: (a) Plan type? (b) D6010 covered? (c) Coverage %? (d) Annual max remaining? (e) Waiting period status?

  4. 4

    Submit pre-treatment estimate

    We submit X-rays, CBCT, treatment plan. Cigna returns binding written estimate before scheduling.

Implant Success Rates (The Data)

10-year survival ~94.6% per Moraschini 2015 systematic review.

Source: PubMed Moraschini systematic review.

AAID: success over 95% with experienced clinicians on healthy candidates per American Academy of Implant Dentistry.

20-year survival 80–90% in well-maintained patients per AAOMS and NIH NIDCR data.

Authoritative Resources

Related Pages on This Site

Insurance We Accept

All carriers including Cigna.

Implants in Boise

Procedure page.

Cost of Implants

Real Boise pricing.

Delta Dental + Implants

Sister insurance page.

BCBS of Idaho + Implants

Sister insurance page.

Dr. Kimball Mack, DMD

Implant lead.

Frequently Asked Questions

Is Lamb Family Dental in-network with Cigna?
We accept and file claims for Cigna Dental PPO. In-network status varies by specific Cigna PPO plan tier; we verify network status during your benefits check. For DHMO members, network restrictions are stricter and we’ll confirm before scheduling.
How much does an implant cost with Cigna in Boise?
Single-tooth implant typically $3,500–$6,000 in Boise. With Cigna PPO 1500 at 50% Major and $1,500 annual max, most patients pay $2,500–$3,500 out of pocket. Cigna PPO 2500 reduces out-of-pocket by ~$500 due to higher annual max.
Does Cigna have a waiting period for implants?
Most new individual Cigna Dental PPO plans have 6–12 month waiting periods for Major services. Waiting period can be waived with documented 12 months of prior continuous dental coverage. Group employer plans often waive entirely.
Will Cigna DHMO cover implants?
Cigna Dental Care DHMO is copay-based. Some plans include implants at flat fee schedule ($1,500–$2,500 patient cost). Many DHMO plans exclude implants entirely. Verify your specific DHMO plan documents.
Can I use Cigna in Meridian or Eagle?
Yes, Idaho ZIP doesn’t change Cigna coverage. We see Cigna patients from Meridian, Eagle, Garden City, Star, Kuna routinely.
What if Cigna denies my implant claim?
Denials usually come from plan exclusion (Preventive plan), unmet waiting period, or DHMO restrictions. We submit pre-treatment estimates first to surface these. Appeals filed with X-rays, CBCT, surgical narrative.
Will Cigna pay for the bone graft?
Depends on plan. Bone grafts (D7953, D7950) typically Major at 50% on plans that cover them. Some plans exclude grafting done specifically for implant support. Verify on benefits check.
How long does an implant last? Worth the cost?
Per Moraschini 2015 + AAID, 10-year survival ~94.6%, success rate over 95%. Compared to a bridge (10-year survival 89%, often replaced), implants are typically the most cost-effective long-term tooth replacement.
Can I split implant treatment across two Cigna plan years?
Often yes. Surgical placement (D6010) before December 31 + abutment/crown (D6057/D6065) after January 1 captures two annual maximums. Saves $500–$1,000 on a single-tooth case.
What if I don’t have Cigna or any dental insurance?
LFD savings plan (~20% off cash) plus CareCredit 6/12/18-month no-interest financing. Many uninsured patients complete implant treatment for less than they’d pay on a low-tier dental plan after premiums.

Verify Your Cigna Implant Coverage in 2 Minutes

Real-time benefits check, written estimate, and pre-treatment estimate submission, usually same day.

Call (208) 344-6300 Schedule a Consultation

Last reviewed June 2026 by Dr. Kimball Mack, DMD, co-owner and lead dentist at Lamb Family Dental Implant Dentistry, Boise, Idaho. Idaho dental license D-5587, NPI 1659809200.

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