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TRICARE Dental Plan Benefits and Coverage

Child in dentist chair gives thumbs up
Child in dentist chair gives thumbs up

The TRICARE Dental Plan (TDP) is a voluntary dental insurance program. The dental benefit is administered by United Concordia and is available to eligible active duty family members, eligible National Guard and Reserve members and their family members. It is available both in the continental United States (CONUS) and overseas (OCONUS).

Eligibility

To be eligible to enroll in the TDP, your sponsor must have at least 12 months remaining on their military service committment at the time of enrollment. Eligible family members include spouses and children until age 21 (or age 23 if full time students). You enroll for a 12 month period. 

Costs

Their are 2 costs associated with the TDP, monthly premiums and cost shares. Monthly premiums are based on the sponsor's military status and number of people covered under the plan (one person vs. family). Cost shares are based on the service performed, the sponsor's paygrade, and the location (CONUS/OCONUS) where treatement is received).

Premium

The premium is a "pay ahead" program, that means you pay the premium for this month to get coverage for next month. If the sponsor is on active duty they can set up an allotment to cover the premiums, you can also set up a recurring payment from a checking account or credit/debit card.  

If you fail to make a monthly premium payment, your coverage will end and you won't be able to enroll again for another 12 months.

TRICARE Dental Program Monthly Premiums
Sponsor's Military Status Type of Enrollment

2017 Premium Rates

Active Duty
  • Single: $11.10
  • Family: $28.87
Selected Reserve and IRR (Mobilized Only)
  • Sponsor Only: $11.10
  • Single: $27.76
  • Family: $72.18
  • Sponsor & Family: $83.28
IRR (Non-mobilized)
  • Sponsor Only: $27.76
  • Single: $27.76
  • Family: $72.18
  • Sponsor & Family: $99.94

Cost share

Cost share is what you pay out-of-pocket for specific services. Your cost share is determined by your pay grade and whether you are stationed CONUS or OCONUS. The following table reflects the cost share percentages.

TRICARE Dental Program Cost Share Amounts
Type of Service Pay Grades E-1 - E-4 (CONUS) All Other Pay Grades (CONUS) OCONUS
Diagnostic 0% 0% 0%
Preventative (except sealants) 0% 0% 0%
Emergency Treatment 0% 0% 0%
Sealants 20% 20% 0%
Basic Restorative 20% 20% 0%
Endodontic 30% 40% 0%
Periodontic 30% 40% 0%
Oral Surgery 30% 40% 0%
Other Restorative 50% 50% 50%
Implant Services 50% 50% 50%
Prosthodontic 50% 50% 50%
Orthodontics 50% 50% 50%
Miscellaneous Services (occlusal guard, athletic mouthguard, bleaching) 50% 50% 0%

Plan Maximum Payments

The TDP's contract year runs from May 1 through April 30.  The annual maximum payment is $1,500 per person per contract year, for non-orthodontic services. Payment for certain diagnostic and preventive services is not applied against the annual maximum.

There is a lifetime maximum of $1,750 per person for orthodontic treatment. If a member receives orthodontic services, payments for these services will not exceed $1,750 during the member's eligibility lifetime. Orthodontic diagnostic services will be applied to the $1,500 annual maximum listed above.

There is an annual maximum payment of $1,200 per person per contract year for accident care, after the maximum is reached additional costs will apply to the annual maximum of $1,300 listed above.

Outside the Continental U.S. (OCONUS) Payments

In the OCONUS service area, the Government pays for any costs in excess of the allowable charge up to the billed charge. This applies to all enrollees except Selected Reserve and IRR family members and IRR (other than Special Mobilization Category) members. The Government will not pay for the portion of the member's maximum that has already been paid by MetLife nor will the Government pay for any costs once the maximums have been met.

See our TRICARE Dental Program Overseas page for more information.

Enrollment

To enroll in the TRICARE Dental Program visit the TRICARE enrollment page and enroll online. If you are OCONUS you cannot enroll online, see the instuctions on the enrollment page for more information.

If there is an existing family plan in effect, children will be automatically enrolled on the first day before they are age 1. If the existing plan is for a single family member only, the premium will change from the single plan rate to the family plan rate. 

Related Topics

TRICARE Medical Personnel