TRICARE Dental Program orthodontic coverage: What to know before you start getting care

Do you or your child need braces? You should know that the TRICARE Dental Program covers orthodontic care. Keep reading to learn who qualifies, what’s covered, and how costs work.

“Having straight teeth affects more than your looks,” said U.S. Navy Cmdr. Xiang Li, TRICARE Dental Program, Dental Service Point of Contact, at the Defense Health Agency. “Misaligned teeth can cause functional and developmental issues for patients.”

Who qualifies for orthodontic coverage?

The TDP covers orthodontic treatment for:

Eligible spouses under age 23
Eligible children under age 21
Children who are full-time students under age 23

Keep your records current in the Defense Enrollment Eligibility Reporting System. You can only use this benefit if your eligibility shows in DEERS.

What the TDP covers

The TDP covers these orthodontic services:

Diagnostic casts
Appliances such as braces
Retainers

How costs work

The TDP splits the cost with you. The TRICARE dental contractor pays 50% of the allowable charge, up to the lifetime maximum of $1,750. You pay the other 50%. Your share also depends on your dentist type. With a network dentist, you pay 50% of the TDP allowance, up to the lifetime maximum of $1,750. With a non-network dentist, you pay 50% of the allowable charge, up to the lifetime maximum plus any costs above that amount.

Get a pretreatment estimate first

Ask your dentist for a pretreatment estimate before you start. It shows:

What United Concordia covers
How much they cover
When you make payments
When United Concordia makes payments

Your orthodontist submits a treatment plan to United Concordia. You and your dentist each get a payment schedule.

How United Concordia makes payments

United Concordia bases payments on how long your treatment takes. The payment schedule shows when they pay your dentist. Keep these points in mind:

Stay enrolled in TDP each month United Concordia makes a payment.
Total payments won’t go above the $1,750 lifetime maximum.
If you turn 21 or 23 during treatment, payments reflect your eligible months.
United Concordia sends a new schedule if your treatment plan changes.

Getting orthodontic care overseas

You need a Non-Availability and Referral Form to get care overseas. Request it from:

An overseas military dental clinic
A designated OCONUS point of contact

Any licensed and authorized orthodontist can treat you. Visit https://www.uccitdp.com/home to find https://www.uccitdp.com/tp2opd/ near you. Dentists overseas may ask you to pay up front. With a TRICARE OCONUS Preferred Dentist, you only pay your cost-share, as noted in the TRICARE Dental Program Handbook.

Learn more

For full details on your orthodontic benefit, visit United Concordia’s https://www.uccitdp.com/member/enrollment-and-benefits/orthodontics.html.

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