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News | March 17, 2022

Answering Questions About Your Child’s Oral Health Coverage

By TRICARE Communications

Taking care of your child’s oral health can be a stressful task. The decisions you make can affect their oral health for a lifetime. The TRICARE Dental Program (TDP) is here to help you make the right decisions about your child’s oral health care. You may have questions about how to use TDP to best care for your child’s teeth and gums.
 
Here are some Q&As about your child’s dental coverage.
 
1. When should my child first see the dentist?
The American Dental Association (ADA) recommends children should first visit the dentist within six months of the child’s first tooth appearing, but no later than the child’s first birthday. “As soon as your baby has teeth, he or she can get cavities,” according to the ADA.
 
Children under age 1 may be enrolled in TDP at any time. TDP covers two routine cleanings and two fluoride treatments during a consecutive 12-month period for children age 1 and older.
 
2. How often can my child go to the dentist for a routine cleaning and checkup?
Your child can visit the dentist for routine checkups and cleanings twice within a consecutive 12-month period.
 
3. How do I know if my child’s dental service is covered?
Always check with your dentist on treatments, and request a predetermination when you need to know whether or not a procedure is covered. A predetermination is a claim that the dentist submits before any services are actually rendered for a proposed treatment plan for covered services. This will help you learn how much you’ll be expected to pay for specific dental care. For information on coverage, check the TRICARE Dental Program Handbook. You can also call United Concordia or visit the TDP website to log in to your My Account.
 
4. Do I have to register my child in DEERS?
Yes, you must first register your child in the Defense Enrollment Eligibility Reporting System (DEERS) before the child receives TDP coverage. United Concordia uses DEERS to verify eligibility for dental benefits. This is true for any TRICARE program. Check out the article, “Is Your DEERS Information Up to Date?” to learn more.
 
5. When will my adult child lose eligibility?
Adult children of a TRICARE sponsor will typically lose their TDP coverage after they turn age 21. However, there are exceptions. To remain eligible for TDP benefits after age 21, your adult child must be unmarried and enrolled full-time at an approved institution of higher learning. Also, the child must be receiving at least 50% of financial support from their sponsor. Adult children age 21 and older who attend college remain eligible for TDP coverage until the last day of the month in which they turn age 23, or when their education or college enrollment ends.
 
As outlined in the TRICARE Dental Program Handbook, unmarried children who have a disabling illness or injury that occurred before their 21st birthday also remain eligible for TDP benefits until age 23. The same is true for adults who experience an illness or injury between ages 21 and 23 while attending an approved institute of higher learning.
 
Looking to catch up on the latest dental news? If so, read the latest issue of the TRICARE Dental Program Health Matters NewsletterIn issue 1, you’ll learn about network dentists, tobacco and oral health, preventive dental care, and more. In case you missed it, be sure to check it out.
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