Tricare: Dental — Retirees - Getting out, military health issues - Navy Times

Tricare: Dental — Retirees

Military retirees and their families are eligible to join the Tricare Retiree Dental Program. In addition to those entitled to retired pay, those eligible include “gray area” reservists who qualify for, but are not yet receiving, retired pay because they are younger than 60; spouses and eligible children of enrolled members and certain nonenrolled members; Medal of Honor recipients and eligible family members; eligible children of deceased members; and deceased members’ spouses who have not remarried.

The plan, administered by Delta Dental of California, has a network of more than 100,000 civilian dentists. It provides dental coverage to enrollees in the 50 states, the District of Columbia, Canada, Guam, Puerto Rico, the U.S. Virgin Islands, American Samoa and the Commonwealth of the Northern Mariana Islands.

Enrollees also may receive care from Delta Dental Premier dentists. They are not in the network but will not charge more than the fees they have agreed to with Delta Dental. Enrollees will be responsible for co-payments and deductibles, as applicable, plus any difference between the agreed-upon fees and the TRDP allowable fee.

Enrollees can use other licensed dentists, but may pay more and may have to file claims themselves.

Benefits

The program has an annual maximum rate share of $1,200 per enrollee, a separate $1,500 lifetime orthodontic maximum per enrollee and a $1,000 annual maximum for dental accident coverage. Diagnostic and most preventive services are excluded from maximums and deductibles. Deductibles are $50 per person per benefit year, up to a cap of $150 per family.

Initial covered services include diagnostic, preventive and restorative treatments, sealants, endodontics, periodontics, prosthodontics, orthodontics, oral surgery, general anesthesia, dental accident coverage and emergency services. Some additional major services are available after the first 12 months of enrollment, unless a beneficiary enrolls in the enhanced plan within 720 days of retirement. Then services are covered immediately. These include cast crowns, onlays and bridges; partial and full dentures; orthodontics; and dental implants.

Cost

Premiums are based on five pricing regions and the enrollee’s ZIP code, are adjusted each May 1 and are automatically deducted from retirement pay. Retirees can find the specific premium rates for their ZIP code online at www.trdp.org/pro/premiumsrch.html.

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

Enrollment

Enrollment is voluntary and requires an initial enrollment for 12 months, with an option to continue on a month-to-month basis. Enrollment requires two months of premiums due with a completed application.

Contact: Eligible retirees and family members can enroll at www.trdp.org. For other information, call Delta Dental at (888) 838-8737.