Tricare: Dental — Active Duty and Reserve - Marine Corps Health Issues | Marine Corps Times

Tricare: 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 Inc. 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.

Under a change that took effect July 1, 2007, and was made retroactive to Oct. 17, 2006, Tricare covers dental anesthesia and associated costs for beneficiaries with developmental, physical or mental disabilities, as well as children age 5 and under.

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

Cost. 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 have their premiums cost-shared. For these members, the enrollee pays 40 percent of the monthly premium and the government pays 60 percent. IRR members (other than Special Mobilization Category) and family members of IRR and Selected Reserve members not on active duty are responsible for 100 percent of the monthly premium.

For active-duty family members, monthly premiums are $11.58 for an individual and $28.95 for a family, for the period through Jan. 31, 2009.

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 family enroll. A full list of the premiums is online at http://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: (800) 866-8499; http://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 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 http://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 Companies, 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.