Military Health, Tricare programs - Army Times

Dental — Active duty and reserve

Active-duty dependents and members of the Selected Reserve and Individual Ready Reserve and their family members worldwide are eligible for Tricare Dental Program coverage. United Concordia Companies administers and underwrites the program for the Tricare Management Activity.

Participation is voluntary, and costs vary.

Benefits

The annual maximum benefit payment is $1,200. Certain preventive and diagnostic services do not count against the enrollee’s annual maximum. The program’s lifetime orthodontia maximum is $1,500.

Covered services include diagnostic and preventive care, sealants, fillings, endodontics, periodontics, prosthodontics (crowns, dentures and bridges), orthodontics and emergency services.

If an active-duty, Selected Reserve or Individual Ready Reserve member dies, benefits continue for his enrolled survivors for three years.

Cost

There are two options — Shared Premium Plan and Full Premium Plan.

In the Shared Premium Plan, enrollees pay 40 percent of the monthly premium and the government pays 60 percent. Family members of active-duty, Selected Reserve and IRR (Special Mobilization Category) members and family members of reservists on active duty for more than 30 days are eligible.

In the Full Premium Plan, the service member is responsible for 100 percent of the monthly premium. Enrollment in this plan is available to IRR members (other than Special Mobilization Category) and family members of IRR and Selected Reserve members not on active duty.

For active-duty family members, monthly premiums are $11.05 for an individual and $27.63 for a family through Jan. 31, 2008. For the following 12-month period, Feb. 1, 2008, through Jan. 31, 2009, monthly premiums are due to rise to $11.58 for an individual and $28.95 for a family.

There are four levels of monthly premiums for members of the Selected Reserve and IRR, depending on whether the sponsor, one family member excluding the sponsor, more than one family member excluding the sponsor, or the sponsor and his or her family enroll. A full list of the premiums is online at www.tricaredentalprogram.com/tdptws/enrollees/premiums/reserveguard_premiums.jsp.

The program has a civilian provider network. Enrollees can seek care outside the network, but they may incur additional costs.

Contact

United Concordia, (800) 866-8499; www.tricaredentalprogram.com.

Enrollment

Enrollment is voluntary and requires at least a 12-month service commitment (active duty, reserve or combination). Exceptions are made for reservists with fewer than 12 months left in service but who are called to active duty for certain contingencies.

Members who live within the continental U.S. and are transferred outside it do not have to re-enroll. Sponsors can enroll family members by completing an enrollment form.

Overseas

Family members are seen in most military clinics overseas regardless of their enrollment in Tricare. Those enrolled in the dental program outside the continental U.S. are eligible for the same benefits, but policies and procedures vary depending on location and service provided.

For care from host-nation dentists, dental plan members who do not live in a remote area must get a statement of nonavailability and a referral form and use dentists on the provider list. Those in remote areas outside the U.S. without a fixed dental facility may get routine dental care without the referral form but will need a form for orthodontic care. Contact the local overseas lead agent for information.

There are exceptions to the cost-share requirements for selected members in the service area. See the “Tricare Dental Program Benefit Booklet” online at www.tricaredentalprogram.com/tdptws/forms/TDP_Booklet_Lo_Res.pdf.

Contact

The program’s overseas dental unit, (888) 418-0466, available 24 hours a day, Monday through Friday, in Australia, Bahrain, Belgium, Bolivia, Canada, Colombia, Egypt, Germany, Greece, Iceland, Italy, Japan, the Netherlands, Norway, Panama, Portugal, Saudi Arabia, South Korea, Spain, Switzerland, Turkey and the United Kingdom.

For all other locations: United Concordia Cos. Inc., TDP OConUS Dental Unit, P.O. Box 69418, Harrisburg, PA 17106-9418; (717) 975-5017; fax: (717) 260-7367; e-mail: oconus@ucci.com.