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Tricare Dental Plan Benefits and Coverage
Posted on: 05/11/20


Child in dentist chair gives thumbs up

Note: This article has been updated to reflect the 2020 - 2021 premium rates which increased on May 1, 2020 by an average of $0.75 monthly from the 2019 - 2020 rates.

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 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 treatment 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 you are on active duty you 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.

2020-2021 Tricare Dental Program Monthly Premiums
Sponsor's Military Status   Type of Enrollment
Active Duty
  • Single: $11.60
  • Family: $30.15
Selected Reserve and IRR (Mobilized Only)
  • Sponsor Only: $11.60
  • Single: $28.99
  • Family: $75.37
  • Sponsor & Family: $86.97
IRR (Non-mobilized)
  • Sponsor Only: $28.99
  • Single: $28.99
  • Family: $75.37
  • Sponsor & Family: $103.36

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%

Office Visit

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.

There is an annual maximum payment of $1,200 per person per contract year for accident care.

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.

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 instructions 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. 

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