The TRICARE Retiree Dental Program
The TRICARE Retiree Dental Program (TRDP) was authorized by Congress in 1997 to provide a basic dental program for Uniformed Services retirees and their family members. The U.S. Department of Defense awarded the first five-year contract to administer the TRDP to the Federal Government Programs division of Delta Dental of California. In 2000, further legislation allowed the program to include comprehensive coverage. The Department of Defense awarded Delta Dental the current TRDP contract, effective October 1, 2008. The contract award allows Delta Dental, to continue to administerthe program through September 30, 2013 and has expanded TRDP coverage worldwide to include enrollees living overseas.
The TRDP is a voluntary dental benefits program with 100 percent of the premium paid by the enrollee. Enrollees in the TRDP may be in the Basic Program (group #4600), which offers coverage for basic and preventive services, or in the Enhanced Program (group #4601) or Enhanced-Overseas Program (group #4602), which both offer a full scope of benefits including orthodontics and dental accident coverage. New enrollments in the TRDP are limited to the Enhanced or Enhanced-Overseas Program.
Covered services under the Enhanced TRDP are offered throughout the 50 United States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, the Commonwealth of the Northern Mariana Islands and Canada. Coverage through the Enhanced-Overseas Program is available worldwide for retirees living outside these areas.
The TRDP is supported by both the Delta Dental PPO/DPO and Delta Dental Legion national networks. While enrollees have the option to see any licensed dentist, they are encouraged to seek care from a dentist in one of these networks, where available.*
*Delta Dental does not maintain a dentist network in Canada, American Samoa, the Northern Mariana Islands, or outside any of the other areas mentioned above.
Covered Services at a Glance
| Benefits available during the first 12 months of enrollment:
|
*Delta Dental Pays |
Group #4600 |
|
| Diagnostic services |
100% |
100% |
Preventive services
|
80-100% |
80-100% |
| Basic Restorative services |
80% |
80% |
| Endodontics |
60% |
60% |
| Periodontics |
60% |
60% |
| Oral Surgery |
60% |
60% |
| Dental Accident Coverage |
NAB |
100% |
| Additional services available after 12 months of continuous enrollment: |
| Cast Crowns, Onlays & Bridges |
NAB |
50% |
| Dental Implants |
NAB |
50% |
| Partial/Full Dentures |
NAB |
50% |
| Orthodontics 1 |
NAB |
50% |
| Deductibles & Maximums |
|
Annual Deductible per Patient 2 |
$50 3 |
$50 3 |
| Annual Maximum per Patient 4 |
$1000 |
$1200 |
| Orthodontic Maximum per Patient |
NAB |
$1500 |
| Dental Accident Maximum per Patient |
NAB |
$1000 |
Benefit Year: October 1- September 30
NAB = Not a Benefit
1 Children and adults are eligible for Orthodontics.
2 Does not apply to diagnostic and preventive services covered at 100%, orthodontics, or dental accident coverage.
3 Family deductible limit of $150.
4 Does not apply to diagnostic and preventive services covered at 100%.
|
Claims Information
Basic and Enhanced Program Claims
Claims for TRDP enrollees in the Basic and Enhanced Programs should be sent to:
Delta Dental of California
Federal Government Programs
PO Box 537007
Sacramento, CA 95853-7007
It is important that all TRDP claims be submitted using the retiree’s (sponsor) social security number. Claims may be submitted electronically or by mail. Although special claim forms are not required, a TRDP claim form is available for downloading and printing on this website.
Claims will be processed based on Delta Dental national network processing policies. Frequency limitations, waiting periods, and exclusions for specific benefits are applied based on contractual requirements, as set by the federal government.
Direct payment will be made to all Delta Dental network dentists. When a non-Delta Dental dentist renders services, payment by Delta Dental is made to the patient unless otherwise indicated on the claim. Payments for electronic TRDP claims are sent directly to the dentist, regardless of his or her participation status.
Enhanced-Overseas Program Claims
There is no available dentist network overseas, nor is there any resultant savings or discount for TRDP dental treatment obtained overseas. For services provided by an overseas dentist, Enhanced-Overseas TRDP enrollees will be required to pay in full at the time of service and should obtain a detailed receipt. To be reimbursed, enrollees must submit their claims directly to Delta Dental and include the denti’s full name, address (including city and country) phone number and/or e-mail address, services performed and a list of the teeth treated. Delta Dental will convert the fees to U.S. dollars and make payment directly to the enrollee in U.S. dollars based on the date of service. Benefits under the Enhanced-Overseas TRDP are not assignable to dentists overseas under any circumstances.
An Enhanced-Overseas TRDP claim from is available on this website for enrollees to download and print. Claims for TRDP enrollees in the Enhanced-Overseas Program should be completed, signed and submitted by the enrollee along with the detailed original receipt obtained from the dentist, to Delta Dental at the following address:
Delta Dental of California
Federal Government Programs
PO Box 537006
Sacramento, CA 95853-7006
United States of America
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