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headerLegislativeCenter

Legislative Center

Border Jobs for Veterans Act

H.R. 2835

TRICARE Retiree Dental Program Coverage

Family Dental Office

The Tricare Retiree Dental Program (TRDP) is run like any other insurance program, you make monthly premium payments which authorizes you certain types of care at a discounted or free rate. If you go to a dentist that participates in the program (known as an in-network provider) you will usually pay a lower copay than if you go to an out-of-network provider (the copay is that amount that you have to pay out-of-pocket when getting treatment). It is always best to go to an in-network provider whenever possible, because if you go to an out-of-network provider you may end up stuck with a very large bill.  The program also has limitations on how much it will pay per calendar year for certain services. 

Premiums

Premiums differ based on your geographic location and how many people you wish to insure. Premiums change every January 1. To determine your premium visit the TRDP premium page.  Premiums must be collected automatically through retired pay allotment. However, if you aren't collecting retirement pay, or the amount of your retirement is insufficient to allow the allotment, you'll need to setup Electronic Funds Transfer (EFT) from a bank account or a recurring payment from a credit or debit card . If you don't establish an EFT or credit card payment before your first monthly premium is due, you may lose coverage.

Coverage

Dental Benefits What TRDP Pays What You Pay (co-pay)
Beginning First 12 Months
Diagnostic and Preventive Services such as Exams, X-rays, cleanings, flouride treatments. 100% 0%
Other Preventative Services such as sealants, space mainters 80% 20%
Basic Restorative Services (cast crowns, overlays) 80% 20%
Drugs, endodontic, periodontic, oral surgery and anesthesia services 60% 40%
Emergency services 80% 20%
Dental accident coverage 100% 0%
Added after 12 months of continuous service
Cast, crowns, and onlays 50% 50%
Partial/full bridges and dentures 50% 50%
Orthodontia 50% 50%
Implants 50% 50%

Annual Deductibles and Maximums

The annual deductible is $50 per person or $150 per family, that means that you must pay $50 out-of-pocket before TRICARE will begin making any payments. The annual maximum that TRICARE will pay is:

  • $1,300 per person per year for all services except those covered by TRICARE at the 100% reimbursement rate
  • $1,200 per person per year for dental accident coverage
  • $1,750 per person lifetime coverage for orthodontic services
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