No matter how hard you try - brushing and flossing every day and
visiting your dentist regularly - sometimes there's nothing
you can do to prevent a dental emergency.
But when an emergency does happen - a toothache or a broken
tooth for instance - the TRICARE Dental Program is ready with
coverage for the unexpected.
What is the TDP Dental Emergency Benefit?
The TRICARE Dental Program's emergency benefit is there so
you can find relief in time of need. This is referred to
as palliative emergency treatment. Palliative emergency
treatment is covered on a per-visit basis, and you will
not have a cost-share for this treatment.
To be considered palliative emergency treatment, the
problem you experience has to occur suddenly and unexpectedly
and must require immediate attention.
Your dentist must provide treatment to ease your symptoms.
Palliative emergency treatment is covered when no definitive
care is provided. When a definitive procedure, such as replacing
a filling, is reported on the same day as the emergency treatment,
the emergency treatment will be considered part of the definitive
procedure.
However, if your emergency involves a trip to the emergency room
and treatment by a physician, this is not covered by the TRICARE
Dental Program. You should check with your TRICARE regional
medical contractor about adjunctive dental care coverage in
situations like these.
Other Covered Emergency Services
If you only receive an evaluation of your condition before
your dentist refers you elsewhere for treatment and/or
prescribes medication, the service is considered a limited
oral evaluation. Like palliative emergency treatment, limited
oral evaluations are a covered benefit and there is no cost-share.
Prescriptions are not covered by the TRICARE Dental Program.
In some emergency situations, your dentist may provide a specific
procedure to treat your problem, such as the extraction of a problem
tooth. In circumstances like these, the actual procedure would be
considered for payment and applicable cost-shares will apply.
The TRICARE Dental Program also covers after-hours office visits if
you need to see your dentist after their regular office hours. A
20-percent cost-share applies to these after-hours office visits.
Just call 1-800-866-8499 if you need more information about
emergency care benefits and the associated cost-shares. Your
TRICARE Dental Program Benefit Booklet also lists all covered
emergency and routine procedures. You can view it online at
www.TRICAREdentalprogram.com.
