Remember to confirm coverage with your medical plan or United Concordia (TDP) before treatment to avoid unexpected bills. Image: ORION PRODUCTION/Shutterstock.com
TRICARE has issued a reminder to beneficiaries that while some dental procedures are covered under TRICARE medical plans only when they are tied to a covered medical condition, injury or disease (“adjunctive”).
They also need to be pre-authorized – except in case of emergency. In contrast, routine or restorative dental work remains under TRICARE Dental Program or other insurance.
Medical (with pre-auth): tooth removal after facial trauma, surgery for a jaw fracture, removal of tooth fragments embedded in soft tissue.
Dental (TDP): cleanings, fillings, crowns, most root canals, sealants/preventive care, extractions, and some orthodontics.
Not covered by medical: repairing or replacing a cracked tooth when not linked to a broader medical condition.
The TDP is a separate, premium-based plan for active duty family members, National Guard/Reserve members, and their families. TRICARE urges beneficiaries to confirm coverage with their medical plan contractor or United Concordia (TDP) before treatment to avoid delays or unexpected costs, according to tricare.mil.
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