What Is The Cost Of Tricare Dental Coverage?
If you are a military service member, a retiree, or a family member of someone who serves, you have access to TRICARE. TRICARE is the health care program for uniformed service members, retirees, and their families. It covers medical care, prescriptions, and mental health. But dental coverage is separate. And it can be confusing.
The question is: What is the cost of TRICARE dental coverage? The answer depends on who you are. Active duty service members get their dental care through military dental clinics. Their family members, National Guard and Reserve members, and retirees have different options. The costs vary based on your status, your enrollment, and the plan you choose.
This guide will break down the cost of TRICARE dental coverage. We will explain the different programs, the premiums, the copays, and the annual maximums. We will also look at how to enroll, what is covered, and what is not. By the end, you will have a clear picture of what you will pay for dental care under TRICARE.
What Is TRICARE Dental Coverage?
TRICARE dental coverage is not a single program. It is a collection of programs for different groups of people. The two main programs are:
- TRICARE Dental Program (TDP): For active duty family members, National Guard and Reserve members and their families, and survivors.
- Federal Employees Dental and Vision Insurance Program (FEDVIP): For retirees, their family members, and certain others. This replaced the TRICARE Retiree Dental Program (TRDP) in 2019.
Active duty service members themselves receive dental care at military treatment facilities. They do not need to enroll in TDP or FEDVIP.
Key Features Of TRICARE Dental Coverage
- Worldwide coverage: You can get care wherever you are stationed.
- Two plan options: Standard and High Option for TDP.
- Comprehensive coverage: Includes preventive, basic, and major services.
- No deductibles: For TDP, there are no annual deductibles.
- Annual maximum: There is a cap on how much the plan pays per year.
The Cost Of TRICARE Dental Program (TDP)
The TRICARE Dental Program is for active duty family members, National Guard and Reserve members, and their families. It is administered by United Concordia Companies, Inc. You enroll in TDP, and you pay a monthly premium. You also pay copays for services.
Monthly Premiums
The premiums are based on your sponsor’s status and the number of family members enrolled.
For Active Duty Family Members
| Sponsor Status | Member Type | Monthly Premium |
|---|---|---|
| Active Duty | Sponsor only | $12.71 |
| Active Duty | One family member | $32.46 |
| Active Duty | Two family members | $64.91 |
| Active Duty | Three or more family members | $97.37 |
Note: Premiums are for the Standard Option. The High Option has higher premiums but lower copays.
For National Guard And Reserve Members
| Sponsor Status | Member Type | Monthly Premium |
|---|---|---|
| National Guard/Reserve | Sponsor only | $27.16 |
| National Guard/Reserve | One family member | $68.38 |
| National Guard/Reserve | Two family members | $136.76 |
| National Guard/Reserve | Three or more family members | $205.14 |
Important Note: Premiums are subject to change. Check the TRICARE website for the most current rates.
Copays
TDP has two options: Standard and High. The High Option has higher premiums but lower copays. Here are the copays for each option.
Table: TDP Copays For Active Duty Family Members
| Service Type | Standard Option Copay | High Option Copay |
|---|---|---|
| Diagnostic And Preventive | $0 | $0 |
| Basic Restorative (Fillings) | 20% of cost | 20% of cost |
| Periodontics (Gum Treatment) | 20% of cost | 20% of cost |
| Endodontics (Root Canals) | 20% of cost | 20% of cost |
| Oral Surgery (Extractions) | 20% of cost | 20% of cost |
| Major Restorative (Crowns, Bridges) | 50% of cost | 50% of cost |
| Orthodontics | 50% of cost | 50% of cost |
Important Note: For National Guard and Reserve members, the copays are slightly different. Check the TRICARE website for details.
Annual Maximum
TDP has an annual maximum benefit. This is the most the plan will pay in a plan year. For the Standard Option, the annual maximum is $1,500 per person. For the High Option, it is $2,000 per person.
Once you reach the annual maximum, you are responsible for all remaining costs for the rest of the plan year.
Orthodontic Coverage
Orthodontics is covered under TDP for children under 18 and for some adults. The copay is 50% of the cost. There is a lifetime maximum of $1,750 for orthodontic treatment.
The Cost Of FEDVIP For Retirees
If you are a military retiree, you are eligible for the Federal Employees Dental and Vision Insurance Program (FEDVIP). FEDVIP is administered by the Office of Personnel Management (OPM). You can choose from several dental plans, each with its own premiums and copays.
How FEDVIP Works
- You choose a plan: There are several national and regional dental plans available.
- You pay a monthly premium: The premium depends on the plan you choose and where you live.
- You pay copays: The plan pays a portion of the cost, and you pay the rest.
- Annual maximum: Each plan has an annual maximum benefit.
Average Costs
FEDVIP premiums vary widely. Here are some examples of average monthly premiums for self-only coverage.
| Plan | Monthly Premium (Self Only) | Annual Maximum |
|---|---|---|
| MetLife | $35 – $50 | $1,500 – $2,500 |
| Delta Dental | $40 – $60 | $1,500 – $2,500 |
| Aetna | $30 – $55 | $1,500 – $2,000 |
| United Concordia | $35 – $55 | $1,500 – $2,500 |
Important Note: These are average premiums. Your actual premium depends on your location, the plan you choose, and whether you enroll family members. You can compare plans on the OPM website.
FEDVIP Copays
FEDVIP copays vary by plan. Typically:
- Preventive Care: Covered at 100%
- Basic Restorative: 20% – 30% copay
- Major Restorative: 50% copay
- Orthodontics: 50% copay, with a lifetime maximum
Does TRICARE Cover Dental Implants?
This is a common question. The answer is: sometimes.
- TDP: Dental implants are not covered under TDP. They are considered a major restorative service, but they are specifically excluded.
- FEDVIP: Some FEDVIP plans cover dental implants. Coverage varies by plan. Some plans cover them at 50% up to the annual maximum. Others exclude them entirely.
Important Note: If you need a dental implant, check your specific FEDVIP plan’s brochure. If you have TDP, you will have to pay for the implant out of pocket.
What Is Not Covered By TRICARE Dental Coverage?
TRICARE dental coverage does not cover everything. Here are some common exclusions:
- Cosmetic Dentistry: Teeth whitening, veneers, and bonding for cosmetic reasons.
- Dental Implants: Under TDP.
- Orthodontics for Adults: Under TDP, orthodontics is only covered for children under 18. FEDVIP may cover adult orthodontics.
- Mouth Guards: For sports.
- Lost or Stolen Dentures: Replacement is not covered.
- Services Not Deemed Medically Necessary: Any procedure that is not medically necessary.
How To Enroll In TRICARE Dental Coverage
Enrolling in TRICARE dental coverage is a separate process from enrolling in TRICARE health coverage. Here is how to do it.
For TDP
- Check Your Eligibility: You must be an active duty family member, National Guard/Reserve member, or a survivor.
- Enroll Online: Go to the TRICARE Dental Program website.
- Enroll By Phone: Call 1-844-653-4061.
- Enroll By Mail: Download the enrollment form and mail it in.
Important Note: You can enroll at any time. There is no open season for TDP. However, there may be a waiting period for certain services.
For FEDVIP
- Check Your Eligibility: You must be a retiree, a family member of a retiree, or a certain other eligible person.
- Wait For Open Season: FEDVIP has an annual open season, usually from mid-November to mid-December. You can enroll or change plans during this time.
- Enroll Online: Go to the BENEFEDS website.
- Enroll By Phone: Call 1-877-888-3337.
Important Note: If you have a qualifying life event (like marriage, birth, or retirement), you can enroll outside of open season.
TRICARE Dental Coverage Vs. Private Dental Insurance
How does TRICARE dental coverage compare to private dental insurance? Here is a comparison.
Table: TRICARE Dental Vs. Private Dental Insurance
| Feature | TRICARE Dental (TDP) | Private Dental Insurance |
|---|---|---|
| Monthly Premium | $12 – $97 | $30 – $70 |
| Annual Maximum | $1,500 – $2,000 | $1,000 – $2,000 |
| Deductible | None | $50 – $100 |
| Preventive Care | 100% covered | 100% covered |
| Basic Restorative | 20% copay | 20% – 30% copay |
| Major Restorative | 50% copay | 50% copay |
| Orthodontics | Covered for children | Often covered for children |
| Implants | Not covered | Sometimes covered |
| Worldwide Coverage | Yes | Limited |
The Takeaway: TRICARE dental coverage is generally more affordable than private dental insurance. The premiums are lower, and there are no deductibles. However, the annual maximums are similar, and some services (like implants) are not covered.
What Do Patients Say?
We spoke to three TRICARE beneficiaries about their experiences.
Jessica, 32, is an active duty spouse.
“I have TDP for myself and my two kids. I pay about $65 a month. The cleanings and X-rays are free. My son needed braces, and we paid 50% of the cost. It was still expensive, but better than paying full price. I think it is a good deal.”
Robert, 62, is a military retiree.
“I have FEDVIP through Delta Dental. I pay about $45 a month. The coverage is good. I had a crown last year, and I paid about $600 out of pocket. My annual maximum is $2,000. I wish it was higher, but it is what it is.”
Maria, 45, is a National Guard spouse.
“My husband is in the National Guard. We have TDP. The premiums are higher for Guard families, but it is still worth it. I had a root canal and a crown. I paid about $800 total. Without insurance, it would have been $2,500.”
Frequently Asked Questions
Q: Is TRICARE dental coverage free?
A: No. Active duty service members receive free dental care at military facilities. However, family members, Guard/Reserve members, and retirees must pay premiums and copays for TDP or FEDVIP.
Q: How much does TRICARE dental cost per month?
A: For active duty family members, TDP premiums range from $12.71 for the sponsor to $97.37 for three or more family members. For retirees, FEDVIP premiums range from $30 to $60 per month for self-only coverage.
Q: Does TRICARE cover braces?
A: Under TDP, orthodontics is covered for children under 18. There is a 50% copay and a lifetime maximum of $1,750. Under FEDVIP, some plans cover adult orthodontics.
Q: Does TRICARE cover dental implants?
A: TDP does not cover dental implants. Some FEDVIP plans cover implants, but coverage varies. Check your plan’s brochure.
Q: Can I see any dentist with TRICARE dental coverage?
A: You can see any dentist who participates in the TRICARE Dental Program or your FEDVIP plan. If you see a non-participating dentist, you may pay more.
Q: How do I find a dentist who accepts TRICARE?
A: You can use the provider search tool on the TRICARE Dental Program website or your FEDVIP plan’s website. You can also call customer service for a list of dentists in your area.
Q: What happens if I reach my annual maximum?
A: Once you reach your annual maximum, you are responsible for 100% of the cost of any additional services for the rest of the plan year. The maximum resets at the beginning of the next plan year.
Conclusion
The cost of TRICARE dental coverage depends on who you are. Active duty family members pay low premiums through the TRICARE Dental Program. Retirees choose from several FEDVIP plans with varying premiums and copays. While the coverage is generally affordable, there are limitations. Dental implants are not covered under TDP. Orthodontics is limited to children under 18. Annual maximums cap the amount the plan pays. Despite these limitations, TRICARE dental coverage is a valuable benefit for military families. It provides access to quality dental care at a reasonable cost. If you are eligible, take advantage of it. Your smile and your wallet will thank you.
Additional Resources
For more information on TRICARE dental coverage, visit the TRICARE Dental Program website at tricare.mil/dental. For FEDVIP information, visit the BENEFEDS website at benefeds.com. You can also contact the TRICARE Dental Program at 1-844-653-4061.
