FALLS CHURCH, Va. –
Do you or your child need braces? You should know that the
TRICARE Dental Program covers
orthodontic care. Keep reading to learn who qualifies, what’s covered, and how costs work.
“Having straight teeth affects more than your looks,” said U.S. Navy Cmdr. Xiang Li, TRICARE Dental Program, Dental Service Point of Contact, at the Defense Health Agency. “Misaligned teeth can cause functional and developmental issues for patients.”
Who qualifies for orthodontic coverage?
The TDP covers orthodontic treatment for:
- Eligible spouses under age 23
- Eligible children under age 21
- Children who are full-time students under age 23
Keep your records current in the Defense Enrollment Eligibility Reporting System. You can only use this benefit if your eligibility shows in DEERS.
What the TDP covers
The TDP covers these orthodontic services:
- Diagnostic casts
- Appliances such as braces
- Retainers
How costs work
The TDP splits the cost with you. The TRICARE dental contractor pays 50% of the allowable charge, up to the lifetime maximum of $1,750. You pay the other 50%.
Your share also depends on your dentist type. With a network dentist, you pay 50% of the TDP allowance, up to the lifetime maximum of $1,750. With a non-network dentist, you pay 50% of the allowable charge, up to the lifetime maximum plus any costs above that amount.
Get a pretreatment estimate first
Ask your dentist for a pretreatment estimate before you start. It shows:
- What United Concordia covers
- How much they cover
- When you make payments
- When United Concordia makes payments
Your orthodontist submits a treatment plan to United Concordia. You and your dentist each get a payment schedule.
How United Concordia makes payments
United Concordia bases payments on how long your treatment takes. The payment schedule shows when they pay your dentist.
Keep these points in mind:
- Stay enrolled in TDP each month United Concordia makes a payment.
- Total payments won’t go above the $1,750 lifetime maximum.
- If you turn 21 or 23 during treatment, payments reflect your eligible months.
- United Concordia sends a new schedule if your treatment plan changes.
Getting orthodontic care overseas
You need a
Non-Availability and Referral Form to get care overseas. Request it from:
- An overseas military dental clinic
- A designated OCONUS point of contact
Any licensed and authorized orthodontist can treat you. Visit United Concordia to find TRICARE OCONUS Preferred Dentists near you.
Dentists overseas may ask you to pay up front. With a TRICARE OCONUS Preferred Dentist, you only pay your cost-share, as noted in the TRICARE Dental Program Handbook.
Learn more
For full details on your orthodontic benefit, visit United Concordia’s
Orthodontic Coverage Information.
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