Orthodontic Cost-Shares
For orthodontic services received OCONUS, you are responsible to pay a 50-percent cost-share.
However, the Government will pay any difference between the remaining 50 percent and the
$1,500 lifetime maximum in orthodontic benefits. The Government will also pay any difference
between the orthodontist’s charge and United Concordia’s allowance (except for National
Guard/Reserve, IRR family members and IRR [other than Special Mobilization Category] enrollees).
Although coverage is available for National Guard/Reserve and IRR family members and IRR (other than Special Mobilization Category) members, all cost-shares and excess charges are the responsibility of the member.
Orthodontic Payments
United Concordia will make payment in one lump sum for overseas orthodontic services, subject
to approval of the OCONUS orthodontist’s treatment plan. Payment will be made to either the
orthodontist or patient, depending on which party submitted the claim. If the patient submits
the claim, but would like the payment to be issued directly to the orthodontist, he or she
must sign the portion of the claim that assigns benefits to the orthodontist.
