WHAT'S COVERED

The TRICARE Dental Program (TDP) provides comprehensive dental benefits for active duty uniformed service family members and National Guard/Reserve members and their families. Benefits include:

$1,500 Annual Benefit Maximum
$1,750 Orthodontic Lifetime Maximum
- Orthodontic payments are made on a monthly basis throughout the course of treatment
$1,200 Dental Accident Coverage

The following chart provides an overview of the TDP covered services and their respective cost-shares. The TDP benefits are the same for the CONUS service area as they are for the OCONUS service area.

Please note: The TDP provides selected services including endodontic, periodontic, and oral surgery at a reduced cost-share for members who are grades E-1 to E-4. For more detailed information about the TDP covered services, see the TDP Dental Reference Guide.

Member Cost-Share

Covered Services	CONUS Service Area		OCONUS Service Area
Pay Grades	Pay Grades E-1 - E-4	Pay Grades E-5 and above	Command-Sponsored Beneficiaries¹
Diagnostic Exams - 2 in a consecutive 12-month period by same provider. Additional exam covered by different provider Periodontal evaluation - 1 in a consecutive 12-month period, per office Full mouth x-ray (complete series or panoramic x-ray) - 1 in 36 months Bitewing x-rays - 1 in a consecutive 12-month period	0%	0%	0%
Preventive² Cleanings - 2 in a consecutive 12-month period. 3rd cleaning is allowed for pregnant patients and patients diagnosed with diabetes, coronary artery disease (heart), cerebral vascular disease (stroke), rheumatoid arthritis, lupus, oral cancer and recipients of an organ transplant. Topical fluoride treatments – 2 in a consecutive 12-month period Space maintainers under age 19	0%	0%	0%
Emergency Services Emergency treatment of dental pain	0%	0%	0%
Sealants Sealants on permanent molars through age 18	0%	0%	0%
Consultation/Office Visit Diagnostic consultation by additional dentist Office visit after regular hours	20%	20%	0%
Post-Surgical Services	20%	20%	0%
Basic Restorative Fillings (amalgam and resin) Resin-based composite crowns on anterior (front) teeth – 1 in a consecutive 12-month period. Prefabricated resin crowns – once per tooth per lifetime on anterior primary teeth, anterior permanent teeth through age 14 or as result of accidental injury. Prefabricated stainless steel crowns with resin windows – once per tooth per lifetime. On primary anterior and premolar teeth to any age, on permanent anterior and premolar teeth through age 14.	20%	20%	0%
Endodontic	30%	40%	0%
Periodontic Surgical and non-surgical periodontic services Additional benefits for members with a qualifying medical condition Periodontal scaling and root planing – 1 in 24 months for each area of the mouth Crown lengthening – once per tooth, per lifetime	30%	40%	0%
Oral Surgery	30%	40%	0%
General Anesthesia	40%	40%	0%
Intravenous Sedation	50%	50%	0%
Miscellaneous Services (occlusal guard, athletic mouth guard)	50%	50%	0%
Other Restorative Crowns, onlays, buildups and posts and cores – 1 in 5 years	50%	50%	50%
Implant Services	50%	50%	50%
Prosthodontic Fixed and removable prosthetics	50%	50%	50%
Orthodontic³	50%	50%	50%
Medications	50%	50%	0%

OCONUS cost shares only apply to command-sponsored enrollees receiving care in OCONUS service areas. These cost shares do not apply Selected Reserve (Sel Res) and Individual Ready Reserve (IRR) family members and IRR (other than special mobilization category) members. Beneficiaries in this category and/or non-command sponsored members are subject to CONUS cost-share arrangements as noted in the middle two columns above.
Space maintainers for posterior teeth for patients under age 19 are fully covered.
Orthodontic treatment is covered for the following enrolled family members:
- Children up to age 21 or 23, based on student status
- Spouses up to age 23
- National Guard/Reserve sponsors up to age 23

United Concordia recognizes and appreciates the important role that you - our partnering dentists - play in helping members understand their benefits. To this end, several information sources are available to you. A complete listing of program policies and procedures is included in your updated TDP Dental Reference Guide. Additional updates and information will be communicated to you in future editions of the Connection, as well as the web site.

THE TDP INCLUDES TDP WELLNESS PROGRAM

Improved benefits for people with certain chronic medical conditions and gum disease

Patients enrolled in the TDP who have been diagnosed with a chronic illness and periodontitis (gum disease) are eligible for improved dental benefits through TDP Wellness Program. Getting the proper treatment and maintenance for gum disease will have a positive effect on their overall wellness as scientists continue to uncover connections between certain chronic conditions and gum disease.

TDP Wellness Program is for people with the following chronic medical conditions:

Cerebral Vascular Disease (stroke)
Coronary Artery Disease (heart)
Diabetes
Lupus
Oral Cancer
Organ Transplant
Rheumatoid Arthritis
Pregnancy (additional, third cleaning in a consecutive 12-month period, only)

Patients can register to use TDP Wellness Program any time after their TDP effective date. Here’s how:

Visit uccitdp.com
Sign into My Account (or create an account)
Click Manage My Oral Health
Add your medical condition

With TDP Wellness Program patients get full coverage for periodontal services, including surgical procedures, to remove the financial obstacles to total oral care.

Improved Benefits

Service	Coverage
Periodontal maintenance – an additional service per year	100%*
Scaling and root planing	100%*
Periodontal surgery – four procedures**	100%*

* Standard frequency limitations apply

** Four procedures related to gingival flap or osseous surgeries

The program also includes email outreach designed to educate and encourage you to stay on track with your oral care to better manage your condition. You can request to receive regular monthly emails full of tips to keep you aware of the importance of oral health.