If you see a participating dentist and authorize the dentist to be paid directly by CIGNA, there will not be a reimbursement to you. If you use a non-participating dentist, your claim will be processed and a reimbursement will be sent to you.

Cleaning for adults is covered every three months. Exams are covered every six months (if using a participating dentist, there is a $15 co-payment). 

The $150 co-payment is for a plain metal crown. If you and your dentist agree to use a precious metal crown, there will be additional cost to you.

Crowns, bridges and dentures can be replaced after five years.

If your tooth was impacted, it is considered a medical condition and therefore, the charge must be submitted to your health insurance provider. You may submit any unpaid balance to CIGNA with a copy of the explanation of benefits from your health insurer. CIGNA will pay up to the scheduled amount. 

Anesthesia is covered only if you are having surgery, like a tooth extraction.

As of Nov. 1, 2024, teachers and other pedagogues approved for this benefit receive $575 a week for up to 52 weeks, while paraprofessionals and other groups in the same salary range receive $475 per week for up to 52 weeks.

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The maximum is 52 weeks based on an individual claim.

Yes. For pedagogues, there is a 28-day unpaid waiting period after your sick bank is exhausted and you have been removed from the DOE payroll. For non-pedagogical employees and paraprofessionals, there is a 14-day unpaid waiting period which begins after you have been removed from the DOE payroll.

No, these are the limits for routine pregnancies. There are many variables that could affect the duration of maternity benefits. You should always apply and UFT Welfare Fund representatives will review your options with you.