The Tricare Dental Plan (TDP) is a deliberate program. Managed by the United Concordia, the dental services are accessible to eligible Reserve individuals and their relatives as well as eligible National Guard and active duty family members. It is accessible both in the United States (CONUS) and abroad (OCONUS).

Eligibility

military service

To be selected into the Tricare dental program, your sponsor must have at least a year of military service completed at the time of registration. Eligible relatives include a spouse and all children until the age 21 (or age 23 if they remain a full-time student).

Cost

There are two costs related to the TDP:

  •  Month to month premiums depend on the sponsor's military status and the number of individuals secured under the plan (one individual vs. a full family of six, for example)
  • A cost-share takes into account the specific service you need, which add-on services you want, the pay scale of your sponsor, and the area or state where you receive your services.

Monthly Premium

The premium is a "pay ahead" program that implies you pay the premium during the current month in exchange for coverage for the next month. If the sponsor is ever on active duty military service, they can set up an allocation to cover the premiums. You can likewise set up a repeating installment from a bank account or credit/debit card.

Unfortunately, there are consequences for failing to pay, so it’s important to make sure your payments are received even if you are on active duty. On the off chance that you neglect to make a month to month premium installment, services will end and you won't be able to enlist again for a year.

Rates vary based on your needs and the size of your family. The following image has more in-depth information on TDP premium rates based on military status and type of enrollment.

TDP monthly premium

Cost Share

Cost share is what you pay out of pocket for particular services. Your cost share is controlled by your pay scale review and whether you are positioned as CONUS or OCONUS. The following table shows the specific cost share rates based on the type of service or treatment you may need.

Type of Service
TRICARE Dental Program
TRICARE Retiree Program
Diagno​​​​​stic, Preventive (except sealants)
0%
0%
Sealants
0%
20%
Basic Restorative
CONUS: 20%
OCONUS COMMAND SPONSORED: 0%
20%
Endodontic, Periodontic, Oral Surgery
Pay grades E-1 through E-4: 30%
All others: 40%
OCONUS COMMAND SPONSORED: 0%
40%
Prosthodontic, Implant, Orthodontic
50%
50%*
*Cost-sharing begins after you have been in the TRDP for more than one year.

Payments

Knowing how much your coverage is going to cost you and how you can make payments are one of the most important things to consider when it comes to dental coverage. Contract details vary and payments don’t cover all types of services, so it’s important to know how you’ll be charged and weigh the cost.

Plan Maximum Payments

The Tricare dental plan contract starts from May 1 through April 30. The yearly maximum installment is $1,500 per individual per contract year, for non-orthodontic administrations. Payment for various diagnostic and preventive services isn't added against the yearly maximum payment.
There is a lifetime cost of $1,750 per individual for orthodontic treatment, for example. In the event that a member gets orthodontic services, installments for these administrations won't surpass $1,750 amid the member's eligibility lifetime. Orthodontic demonstrative services will be added to the $1,500 yearly maximum recorded previously.
There is also an annual maximum payment of $1,200 per individual per contract year for accidental care. After the maximum is reached, the extra expenses will apply to the yearly maximum of $1,300 recorded previously.

Making Payments Outside of the Continental U.S. (OCONUS)

With OCONUS services, the Government covers any cost over your coverage amount on the charged bills. This applies to all enrollees with the exception of Selected Reserve and IRR relatives and IRR (besides Special Mobilization Category) members. The government will not pay for the services of the member's maximum that has just been paid by insurance company, nor will the government pay for any costs once the maximums have been met.

Enrollment

To enroll in the program, visit the Tricare registration page and sign up on the web. On the off chance that you are OCONUS, you can't register online and must see the instructions on the registration page for further information.

If there is an existing family plan, kids will be consequently selected on the first day before they are a year old. If the existing plan is for a single relative, the premium will be replaced by the single plan rate to the family plan rate.

New Changes

Present Tricare retiree dental plans (TRDPs) will end on December 31, 2018. Any current retirees and or members have the alternatives to choose a dental plan using the Federal Employee Dental and Vision Insurance Program (FEDVIP). Even better, a vision plan can also be accessed using the new program, and for much more people than just retirees and their families.

In the US, there has been an absence of vision coverage through government-sponsored programs. But soon that will soon no longer exist, as retired military personnel and their families are now included. In recent years, the same program was just accessible to both current and retired Federal and US Postal Service (USPS) employees as well as their eligible relatives.


How Will the Changes Personally Affect My Life?

dental benefits

Changes will not go into effect during 2018. Starting in November, members should pick a new FEDVIP plan. As the current administrator of the TRDP, Delta Dental allows you and your family members to choose from a database filled with ten national and local dental carriers and four vision carriers.

The uplifting news is that there will be more choices and adaptability as well as more premium options than were offered before. Federal Employee Dental and Vision Insurance Program premiums are deducted from Tricare enrollees' post-tax pay. Those who qualify can select from either a dental or a vision plan, no plan, or both plans. The decision is yours.

Members that are active in the military and family members will continue dental coverage as before, yet they will have the capacity to pick your vision plan through the FEDVIP, which will help families in the military save their money.

The alternative to choose the right carrier for you provides active members and retirees with the flexibility to weigh options and consider other plans, saving cash in the long run. You will have the chance to select the plan that is ideal for you and your family, based on your own needs.

Some of the new dental carriers that are now available include the following:

  • Aetna Dental
  • Humana
  • Dominion Dental
  • FEP Blue Dental
  • Triple-S Salud
  • Delta Dental
  • Emblem Health
  • GEHA
  • United Concordia Dental
  • MetLife

The list of vision carriers also now includes:

  • Vision Service Plan
  • Aetna Vision
  • United Healthcare Vision
  • FEP Blue Vision

The Newest Addition: Vision Coverage

dental vision-coverage

In 2019, one of the best parts of this plan will go live. Most retired personnel and active duty family members can begin to register in the federal vision insurance program.
As of now, vision coverage is not part of Tricare.

While beneficiaries currently get one standard eye exam free every year or each year, it is contingent upon their coverage plan, health issues such as whether they’re diabetic. Eye exams for contacts are not in the program, nor are the contacts or glasses themselves.

Regardless, with the FEDVIP vision program, you won't just have a covered eye exam at the same time. Contingent upon your decision of the coverage, you might have the capacity to get glasses, contacts or both free of cost or at an amazing discount. Tricare will proceed with its present coverage system for people who don't choose the new vision plan option.

According to Military.com, there are currently four insurers accessible in the FEDVIP vision program. Month to month family premiums also run from $19 to $43.
Similar to the FEDVIP program, members can select one of many different eye care providers, with more options than presently part of Tricare, and they can customize plans to fit individual needs.

Important Deadlines to Watch For in 2018

Staying on top of important deadlines can help you make sure you don’t miss any changes or miss out on selecting the coverage you want. Below are the big deadlines to keep an eye on in 2018:


November 12, 2018: Registration starts in November 2018. This means you will have the capacity to register in the new FEDVIP plan amid "open season." You will have the chance to sign up from November 12 to December 10. Opportunities are accessible to roll out “qualifying life events” like having a child or moving across the country, excluding open season, so this is your window to register. Make a point to stamp this date on your calendar now.


December 10, 2018: The last day to register for FEDVIP plans.


December 31, 2018: Old TRDP plans will become expired on Dec. 31, 2018. Register with FEDVIP before this date so as to get proceeded with dental care as you won't be automatically selected in the new coverage plan.


January 1, 2019: As soon as you are registered, the coverage will start from January 01, 2019.

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