Whether you’re seeing the dentist for a routine checkup or getting emergency dental care, the TRICARE Dental Program (TDP) covers a wide variety of dental services for active-duty family members, as well as National Guard and Reserve members and their family members. If you visit a network dentist, you will only have to pay a cost share or a percentage of the total cost of those services.
“Who you are, where you live and the type of service you need determines your cost share for covered services with a network dentist,” said Doug Elsesser, program analyst at the Defense Health Agency’s TRICARE Dental Program. “If you see an out-of-network dentist for services covered by the TDP, you may pay more out of pocket and have to file a claim.”
It is important to know what services TDP covers before your next dental visit. Here’s a look at some of them.
Diagnostic services
These are services to monitor you for oral health issues. The TDP covers:
- Two tests in a consecutive 12-month period from the same provider and one additional test from a different provider
- One periodontal evaluation in a consecutive 12-month period per office visit
- Annual x-rays in a consecutive 12-month period per office visit
There is no co-pay for diagnostic services from your regular dentist. If you receive a diagnostic consultation from an additional dentist or go to a dental office after normal hours, you may have a 20% cost share.
Preventive services
These are services that protect your teeth and gums from tooth decay and infection. The TDP covers two routine dental cleanings in a consecutive 12-month period for each enrollee. It also covers a third dental cleaning for registered pregnant women and those diagnosed with certain conditions chronic medical conditions;. To receive this allowance, you must register My account. Other common preventive services include:
- Fluoride treatments
- Groundskeepers (fully covered for children under 19)
- Space maintenance care
- Sealants (fully covered for permanent molars or back teeth, up to age 18)
There is no cost sharing for preventive dental care when you see a network dentist.
Restoration services
The TDP covers many restorative services to repair broken or cracked teeth and to protect teeth from tooth decay. As noted in TRICARE Dental Program Handbookyou can get coverage for restorative services needed due to tooth decay, tooth fracture, abrasion, erosion, abrasion, or birth or developmental defects. Aesthetic reasons are excluded.
Covered services include:
- Amalgam fillings (silver).
- Resin-based composite fillings (tooth-colored).
- Crowns
- Veneers (in some cases)
There is no remediation cost share for mandate-sponsored enrollees in the TDP OCONUS service area. All other TDP enrollees have a 20% cost share.
Other services
Other services covered by the TDP include:
- Periodontal services
- Orthodontic services
- Endodontic services (including root canals)
- Oral surgery
- Implants
There are some services that TDP does not cover. Always talk to your dentist before having any major dental procedures to make sure you understand if the recommended procedures are covered and in what amounts.
To learn more about the services covered by the TDP, see TRICARE Dental Program Handbook. You can also go to Benefits or login to My account to see a list of what’s covered.
Looking for more information about TDP, including oral care tips? Check out the latest TRICARE Dental Program Health Matters Fact Sheet.
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