Ways To Enroll

WHAT'S COVERED

The following chart provides an overview of the TDP covered services and their respective cost-shares. 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 TRICARE Dental Program Benefit Booklet.

Maximum Benefits

Maximum	Amount
Annual Benefit Maximum	$1,500 per enrollee
Orthodontic Lifetime Maximum (See age limitations in Orthodontics Section below)	$1,750 per enrollee
Dental Accident Coverage Annual Maximum	$1,200 per enrollee

Participant Cost-Share

Covered Services	CONUS Service Area		OCONUS Service Area
Covered Services	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:
- National Guard/Reserve sponsors up to age 23

Improved Benefits

If a sponsor or covered family member has been diagnosed with a chronic illness and periodontitis (gum disease), TDP Wellness Program is available to provide additional dental benefits at no cost. Getting the proper treatment and maintenance for gum disease will have a positive effect on the beneficiary’s 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)

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

Visit uccitdp.com
Sign into My Account using your DS Login
Click Manage My Oral Health
Add your medical condition

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

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

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 enrollees to stay on track with their oral care to better manage their condition. Enrollees can request to receive regular monthly emails full of tips to keep them aware of the importance of oral health.

DENTAL COSTS

The TRICARE Dental Program (TDP) is an affordable option for eligible beneficiaries. With Government-shared premiums and cost-shares, beneficiaries get the most coverage for minimal out-of-pocket costs.

Member cost-shares vary depending upon the sponsor's pay grade. A complete list of cost-shares and premiums is available in the sections below.

PREMIUMS

The TDP monthly premium is determined by the sponsor’s military status (Active Duty, Selected Reserve or Individual Ready Reserve [IRR]) and the enrollment plan (single or family).

For enrolled active duty family members (ADFMs), Selected Reserve and IRR members in the Special Mobilization category, the Government assumes 60 percent of the cost of the TDP premium while the sponsor pays 40 percent. IRR members in a category other than Special Mobilization, and all Selected Reserve and IRR family members, are responsible for the full amount (100%) of the monthly premium cost.

If the sponsor’s military status changes during TDP enrollment, the enrollment plan will automatically be updated accordingly.

PREMIUM AMOUNTS

Note that TDP premium amounts change annually on May 1st.

The following chart indicates the sponsor’s monthly premium responsibility for the enrollment period May 1, 2017 – April 30, 2018.

Premium Amounts

Your TDP premium amounts change annually on May 1st.

The following chart indicates your monthly premium responsibility for the enrollment periods of May 1, 2021 – April 30, 2022 and May 1, 2022 - April 30, 2023.

Sponsor's Military Status	Type of Enrollment
05/01/2021- 04/30/2022	05/01/2022 - 10/31/2024
Active Duty
Single:$11.94	Single: $12.36
Family: $31.04	Family: $32.13
Selected Reserve and IRR (Mobilization Only)
Sponsor: $11.94	Sponsor: $12.36
Single: $29.84	Single: $30.89
Family: $77.59	Family: $80.33
Sponsor and Family: $89.53	Sponsor and Family: $92.69
IRR (Non-Mobilization)
Sponsor only: $29.84	Sponsor only: $30.89
Single: $29.84	Single: $30.89
Family: $77.59	Family: $80.33
Sponsor and family: $92.69	Sponsor and family: $111.22
Survivor (both premiums are 100% Government paid)
	Single: 100% Government paid
	Family: 100% Government paid

Premiums are paid on a monthly basis and must be paid in full. There are no circumstances when a partial premium can be paid. If a beneficiary fails to pay premiums during the mandatory 12-month enrollment period, the Government will not pay any portion of the premium for the remaining months. Failure to pay the required premiums may result in referral of the account to a collection agency.

PAYING TDP MONTHLY PREMIUMS

Initial Premium Payment

The sponsor will make the first premium payment (for the first month of coverage) during enrollment.

If enrolling online, the sponsor should use a credit card
If enrolling through the mail, the sponsor may pay with a credit card, check or money order. Sponsor Social Security number or DoD Benefits Number should be included in the memo area of a check or money order.

Automated Recurring Payments

The following types of ongoing automated payments are acceptable:

Allotment

Sponsors can set up an allotment for recurring premium payments if a military payroll account and sufficient funds are available

Electronic Fund Transfer (EFT)
Credit/Debit Card

It’s easy to set up recurring payments:

If enrolling online, the sponsor can set up any of the recurring payment types listed above at the same time.
If enrolling by mail, the sponsor must complete Section IV of the TRICARE Dental Program Enrollment Form
- For credit or debit cards the sponsor must include the type of card, card number, expiration date and security code.

Enrollees can also set up recurring payments at any time by logging in to My Account and clicking the "Billing" tab.

Beneficiaries can also elect to pay their bill monthly by choosing that option during enrollment. Monthly payments can be made by regular mail, over the phone, or online with a credit or debit card after logging into their account.

If the sponsor doesn’t pay the monthly premiums, TDP coverage will end. If coverage ends, the sponsor won’t be able to re-enroll for one year.

BENEFITS OF USING A NETWORK DENTIST

When TDP beneficiaries visit a United Concordia network dentist, they:

Have access to an extensive network of dentists – With more than 331,000 office locations across the country, whether they’re home or away from home, finding a network dentist takes only a phone call or mouse click.
Save money – Because there is no deductible and our network dentists accept our negotiated fees or "maximum allowable charges" (MAC) as payment-in-full for covered services, beneficiary out-of-pocket expense is lower. This means no balance-billing. See the sample savings chart below.
Save time – Network dentists agree to file claims so it's one less thing to worry about.
Stretch their benefit dollars – Paying less for care from a network dentist lets them receive more covered services before reaching the annual maximum.
Enjoy peace of mind – All network dentists undergo rigorous review through our quality assurance process and routine verification of their credentials.
Are in-the-know – Upon request, our network providers will submit predeterminations before performing a procedure. So beneficiaries can know up front if the treatment is covered and how much they can expect to pay out-of-pocket.

See How Much Beneficiaries Will Save...

Potential beneficiary savings¹ for an average individual dental visit with United Concordia

Service	Patient Payment Without Coverage	In-Network²		Out-Of-Network
Service	Patient Payment Without Coverage	Pay	Savings	Pay	Savings
1 Adult Cleaning (D1110)	$152	$0	$152	$74	$78
1 Exam (D0120)	$85	$0	$85	$45	$40
1 Set of Bitewing X-Rays (D0272)	$121	$0	$121	$65	$56
1 Filling (Amalgam) (D2140)	$250	$25	$225	$152	$98
1 Crown (D2752)	$985	$258	$727	$727	$258
TOTAL	$1,593	$283	$1,310	$1,063	$530

For illustrative purposes only. Savings shown do not account for premium cost. Savings will vary by dentist, service and geographic region. Sample charges based on Pennsylvania ZIP Code 17110 as of August, 2016.

Assumes all services are performed by a United Concordia TDP Network dentist.