Billing · Updated 2026-09-08 · 6 min read
Cigna DPPO vs DPPO Advantage vs Total DPPO vs DHMO: what's the difference?
Advantage is a deeper-discount fee schedule nested inside the Total DPPO network, not a separate product — and the DHMO is a different product entirely.
Total Cigna DPPO is Cigna's broad dental PPO network, paid on contracted fees. Cigna DPPO Advantage is a narrower sub-network inside it: the same network membership, a deeper discount, and no separate credentialing. That is the whole distinction, and it means an office can be "in network with Cigna" and still be paid two different amounts depending on which fee schedule its contract sits on. Cigna Dental Care is the DHMO — a separate prepaid product with per-code copays, no annual maximum, no deductible, and no coverage out of network except emergencies. On Cigna's commercial PPO plans, out-of-network care is paid at a maximum reimbursable charge; on its retail individual plans it is priced off a basic Advantage fee schedule in the area. Either way the patient owes the balance. Kaylie has not measured how Cigna's networks and tiers divide across offices; what follows is the carrier's stated policy.
What Cigna's own documents say
Cigna's own glossary names both PPO networks in one breath, which is exactly where the confusion starts:
"Advantage or Total network: A network made up of dentists who have contracted with Cigna Healthcare and agreed to accept a predetermined contracted fee for the services provided to Cigna Healthcare customers. Visiting a provider in this network means you'll save the most money because the fee is discounted."
— Cigna Healthcare Dental Individual & Family Plan 3000/100 Schedule of Benefits, Total Network, 2025.
On what a contracted fee is, and what happens outside it:
"Contracted fee: The fee to be charged for a service that Cigna Healthcare has negotiated with a contracted provider on your behalf. The most Cigna Healthcare will pay a dentist for a covered service or procedure for out-of-network dental care is based on a basic Advantage fee schedule within a specified area."
"Out-of-network — Out-of-pocket expenses may be higher; these providers do not offer Cigna Healthcare® customers our contracted or discounted fees… you will pay the out-of-network benefit and the difference in the amount that Cigna Healthcare reimburses for such services (contracted fee) and the amount charged by the dentist (actual billed charge[s])… This is known as balance billing."
— same document. Read those two together and the shape of these retail individual and family plans is clear: out-of-network care is priced off a fee schedule in the area, not off a percentile of what dentists charge. That is the retail rule; the commercial plans an employer buys use a maximum reimbursable charge instead.
On what going out of network does not do:
"All deductibles, plan maximums, and service specific maximums cross accumulate between in and out of network. Benefit frequency limitations are based on the date of service and cross accumulate between in and out of network."
— recurring language across Cigna commercial DPPO summaries. Nothing resets; the patient just gets less for the same accumulator.
Reading across Cigna's carrier and product documents, the relationship between the two PPO networks is that Advantage is nested inside Total: dentists who accept a deeper discount in exchange for higher patient volume, on the same DPPO network membership rather than a separate product. That is a summary of the documents, not a sentence Cigna wrote.
Cigna's DHMO, Cigna Dental Care, is a different product with a different mechanism. The member must use a contracted network general dentist, specialist care runs through referrals, the patient's price comes from a Patient Charge Schedule of per-code copays, and there is no annual maximum and no deductible. Out of network is not covered except in an emergency. It is issued through per-state subsidiaries — Arizona, California, Colorado, Delaware, Florida (as a Prepaid Limited Health Services Organization under Chapter 636 of the Florida Statutes), Kansas covering Kansas and Nebraska, Kentucky covering Kentucky and Illinois, Maryland, Missouri, New Jersey, North Carolina, Ohio, Pennsylvania, Texas and Virginia. The copay amounts are per plan, so there is no carrier-wide table to quote and we will not print one.
Cigna also names indemnity plans alongside the PPO in its clinical guidelines — "For Cigna Dental PPO and Indemnity Plans", Cigna Dental Coverage Determination Guidelines, 2026. No Cigna indemnity benefit summary is published, so this article cannot tell you how one reimburses.
Why it depends on the plan
The tier is not just a fee schedule. On a two-tier plan that pays richer benefits at an Advantage dentist and reduced benefits at a non-Advantage Total Network dentist, the coinsurance, the deductible and the annual maximum all move with the tier. A patient who is "in network" at your office can carry a different annual maximum from the identical patient down the road, because your contract sits on a different schedule.
On the commercial plans an employer buys, the out-of-network basis is the maximum reimbursable charge — a percentile of provider-submitted charges in the area — and the percentile is a purchase the employer makes. Across Cigna plan summaries we have read, the 80th, 85th and 90th percentiles all appear. Cigna does not state a carrier-wide percentile anywhere in the sources, so the honest answer to "what is Cigna's MRC percentile" is: ask the plan.
Three names on a card mean the same national network. In Arizona and Louisiana the DPPO product is branded "CG Dental PPO"; in Texas the insured product is called "Cigna Dental Choice" and uses the national Cigna DPPO network. "Cigna Dental Choice" in Texas has nothing to do with Delta Dental's Choice or Choice Advantage products, which are a different carrier's fixed-copay PPO.
What to do
- Ask which network your contract is on — Advantage or Total — and load the matching fee schedule. This is a property of your contract that the patient's card will not tell you.
- For every Cigna PPO patient, ask three things: the tier they are being paid at, the annual maximum at that tier, and the coinsurance at that tier. On a two-tier plan all three move together.
- Out of network on a commercial plan, ask for the MRC percentile by name. The range across plans is wide enough to move a crown estimate materially, and there is no carrier-wide default to fall back on.
- On a DHMO patient, work from the plan's Patient Charge Schedule and nothing else. Copays are per plan and there is no allowance to apply a percentage to.
- Do not treat "CG Dental PPO" or "Cigna Dental Choice" as unfamiliar carriers. They are the national DPPO network under other names.
- Do not expect a fresh deductible or a fresh frequency clock when a patient goes out of network. Cigna states that they cross-accumulate.
Numbers last refreshed August 2026.