United Concordia is pleased to announce that we have
been selected by the Department of Defense to administer
the next generation TRICARE Dental Program. The new
contract, which begins February 1, 2006, provides
comprehensive dental benefits for active duty uniformed
service family members and National Guard/Reserve members
and their families.
Under the new contract, the annual benefit will remain
at $1,200 and the lifetime orthodontic maximum at $1,500.
However, there are several significant changes to the
existing benefit package. Notably, sealants on permanent
bicuspids are no longer covered, but full mouth debridement,
implant coverage, frenulectomy and frenuloplasty have been
added to the contract. Specific information regarding all
benefits is available in the TDP Dental Reference Guide.
The chart below highlights the more noteworthy changes.
Benefit
2006 Contract
Bicuspid Sealants
Not covered
Implants and Implant Prosthetic Services
Covered at 50%
Subject to $1,200 annual maximum
Not covered when placed for a removable denture
Not covered for patients under age 14 unless
submitted with x-rays and approved by a United
Concordia Dentist Advisor
Replacement limited to once per five years
Full Mouth Debridement
Covered once per 24-month period.
Frenulectomy and Frenuloplasty
Covered. Considered integral when provided on the
same day, by the same dentist as a
frenuloplasty/frenulectomy or
periodontal surgery.
Additionally, beginning with treatment plans starting
February 1, 2006 and after, orthodontic payments will
be made on a quarterly basis throughout the
course of treatment. Payments will continue until the
maximum is met or you notify us that the treatment is
discontinued.
The level of TDP coverage remains unchanged as outlined
in the following chart. Please note that the TDP provides
coverage for selected services at a higher level for pay
grades E-1 to E-4. These include
endodontic, periodontic and oral surgery services.
Space maintainers are fully covered for patients under
age 19 when involving posterior teeth. They are covered
at 80% for patients under age 19 when replacing anterior
teeth only.
United Concordia recognizes and appreciates the important
role that you - our partnering dentists - play in helping
members understand their benefits. To this end, several
information sources are available to you. A complete listing
of program policies and procedures is included in your
updated
TDP Dental Reference Guide. Additional updates and
information will be communicated to you in future editions
of the
Connection, as well as the web site.
