FALLS CHURCH, Va. –
Did you know that February is
National Children’s Dental Health Month? But anytime is the perfect time to emphasize the importance of
good oral health with your child. And part of that involves making sure they have dental coverage. That’s where the
TRICARE Dental Program (TDP) can help. The TDP is a voluntary dental plan administered by United Concordia Companies, Inc. (United Concordia). It provides comprehensive dental coverage to beneficiaries worldwide.
If you’re new to TDP, welcome aboard. Here are some key things you need to know to help you and your family get optimal dental care.
Choosing a Dentist
As a TDP enrollee, you may visit any dentist of your choice. However, choosing a
network dentist is the most cost-effective option.
“Visiting a network dentist can save you money,” said Doug Elsesser with the TRICARE Dental Program at the Defense Health Agency. “You won’t have to pay more than your regular cost-share when you receive a covered service.”
Dentists who haven’t signed a contract with United Concordia are non-network dentists. You can see non-network dentists, but you could pay more out of pocket and may have to
file your own claims for reimbursement. The same is true if you live in the OCONUS region and see a dentist that isn’t a
TRICARE OCONUS Preferred Dentist, or TOPD. You may also have to pay for services before you get care.
To find a network dentist near you, use the
Find a Dentist Tool on the TDP website. You can also download the
TRICARE Dental Program Benefit Brochure to learn more about network and non-network dentists.
Learning about Costs
The TDP
fully covers basic dental care, like routine cleanings, fluoride treatments, and oral exams, when you see a network dentist. If you need a major dental procedure, such as oral surgery, a cost-share (the percentage of the total cost of a covered service you pay) applies. In this case, you can ask your dentist to submit a payment review—also known as a predetermination of payment—to United Concordia. This lets you and your dentist know what services are covered, how much your plan will pay, and how much you can expect to pay. The TDP recommends that you ask your dentist for a predetermination for all proposed dental treatments that may be over an amount you’re comfortable paying.
Understanding Maximums
Another important step to getting affordable dental care is getting to know your maximum. A
maximum is the most the TDP will pay for your care within a certain amount of time. The TDP has three types of maximums:
- Yearly maximum benefit: the most TDP will pay for your dental care per plan year. The TDP plan year is a 12-month period that runs from May 1 to April 30.
- Lifetime maximum benefit for orthodontic treatment: the most the TDP will pay for orthodontic care during your lifetime.
- Accidental yearly maximum benefit: the most the TDP will pay for any dental care you get because of an accident per plan year.
Keep in mind, TDP maximums are per beneficiary. And unused maximums don’t carry over to the next plan year. You can read more about maximums, costs, and TDP covered services in the
TRICARE Dental Program Handbook.
Looking to catch up on the latest dental news? Be sure to check out the latest issue of the TRICARE Dental Program Health Matters Newsletter. You’ll learn about ways to keep your child’s teeth healthy, how much calcium to add to your diet, new premiums for the upcoming TDP plan year, and more.