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Program Overview
We are pleased to present the TRICARE Retiree Dental Program (TRDP), the first and only dental benefits plan created by Congress especially for Uniformed Services retirees and their family members and administered by Delta Dental of California. The information on this site will introduce you to this unique program, from the rules that determine eligibility and a description of the service area that allows you broad access to coverage, to your options in choosing a dentist and instructions on how to enroll in the program—all designed around a comprehensive scope of benefits to help you and your family gain and maintain good dental health.
Under contract with the U.S. Department of Defense, the Federal Services division of Delta Dental of California administers the TRDP with the same high level of quality, service and dependability for which Delta Dental is known nationwide. This unique program offers:
- Comprehensive coverage for the most commonly needed and sought-after dental services with the full scope of benefits available after only 12 months.
- The choice to visit any licensed dentist in the service area, or for more cost savings, to choose from over 90,000 network dentist locations.
- Affordable monthly premiums deducted automatically from Uniformed Services retired pay
Eligibility
You are eligible to enroll in the TRDP if you are:
- A member of the Uniformed Services who is entitled to Uniformed Services retired pay, even if you are 65 or older.
- A member of the retired Reserve/Guard, including those in the “gray-area” who are entitled to retired pay but will not begin receiving it until age 60.
- A current spouse of an enrolled member.
- A child of an enrolled member, up to age 21 (to age 23 if a full-time student, or older if disabled before losing eligibility).
- An unremarried surviving spouse or eligible child of a deceased member who died while in retired status or while on active duty.
- A Medal of Honor recipient and eligible family members, or an unremarried surviving spouse/eligible family members of a deceased recipient.
- A current spouse and/or eligible child of a non-enrolled member with documented proof the non-enrolled member is: (a) eligible to receive ongoing comprehensive dental care from the Department of Veterans Affairs; (b) enrolled in a dental plan through employment and the plan is not available to family members; or (c) unable to obtain benefits through the TRDP due to a current and enduring medical or dental condition. Written documentation supporting any of these three situations must be submitted with your enrollment application.
Former spouses and remarried surviving spouses are not eligible at this time.
Benefits
This chart provides an overview of coverage under the enhanced TRICARE Retiree Dental Program for patients who visit a participating network dentist.
| Benefits available during the first 12 months of enrollment:
|
*Delta Dental Pays: |
| Diagnostic services (such as exams) |
100% |
Preventive services (such as cleanings)
|
100% |
| Basic Restorative services (such as fillings) |
80% |
| Endodontics (such as root canals) |
60% |
| Periodontics (such as gum treatment) |
60% |
| Oral Surgery (such as extractions) |
60% |
| Emergency (such as treatment for minor pain) |
80% |
| Dental Accident Coverage |
100% |
| Additional services available after 12 months of continuous enrollment: |
| Cast Crowns, Onlays & Bridges |
50% |
| Partial/Full Dentures |
50% |
| Orthodontics |
50% |
| Deductibles & Maximums |
|
Annual Deductible
(per person, $150 cap per family, per benefit year) |
$50 |
| Annual Maximum (per person, per benefit year) |
$1200 |
| Orthodontic Maximum (per person, per lifetime) |
$1200 |
| Dental Accident Maximum (per person, per benefit year) |
$1000 |
| Benefit Year: May 1- April 30 |
*The percentage paid by Delta is based on the allowed amount for each procedure. Your out-of-pocket costs may be higher if care is received from a non-participating provider.
Covered benefits are subject to certain limitations. For more information on all covered services and detailed information on benefit levels, limitations, exclusions, program policies and payments for non-participating providers, please see the benefits booklet.
Cost
The TRDP has been designed to provide you and your family with comprehensive dental benefits at an affordable cost. Monthly premium amounts will vary depending on where you live and the number of family members you elect to enroll.
Premium rates will change slightly on May 1 of each benefit year. To find out the current premium rate for your region, please use the premium search available on the web site.
Federal law mandates that monthly premiums for the TRDP be deducted automatically from Uniformed Services retired pay. If it is determined that Uniformed Services retired pay is not available or is insufficient to allow the automatic deduction, Delta Dental will notify you of your premium payment options by mail.
Dentist Network
As an enrolled member of the TRDP, you may visit any licensed dentist within the service area for treatment. To save you even more out-of-pocket expenses, Delta Dental offers a dentist network with over 90,000 locations nationwide. These network dentists have agreed to pre-negotiated fees and to submit all claims paperwork for you.
If you go to an out-of network dentist, Delta Dental pays the same percentage of covered services but cannot guarantee the dentist’s fees. Out-of-network dentists will bill you for their normal fees, which may be higher than the program allowed amount for the service. You will be responsible for paying your copayment plus any difference between the program allowed amount and the dentist’s billed charge.
Service Area
Covered services under the TRDP are offered anywhere in the 50 United States and the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, the Commonwealth of the Northern Mariana Islands and Canada.
Enrollment
Enrollment in the TRDP is voluntary. Each new enrollee electing to enroll must fulfill an initial enrollment period of 12 consecutive months. After the initial 12-month period, you become eligible for the full scope of benefits offered under the TRDP and will continue your enrollment in the TRDP on a month-to-month basis. There is a grace period of 30 days from your coverage effective date during which you may rescind your enrollment agreement without any further obligation, provided you have not used any program services during that time.
If you do not exercise your option to rescind within the 30-day grace period, you must remain enrolled in the program for the duration of the initial 12-month period without further opportunity for voluntary disenrollment.
If you are a new retiree who elects to enroll within 120 days after your retirement from active duty, the National Guard or Reserve, you are eligible for a waiver of the 12-month waiting period for the full scope of benefits. A copy of your retirement orders must be submitted with your enrollment application to verify your eligibility for this waiver. Additionally, if you are retiring soon from the Uniformed Services and wish to enroll in the TRDP with no gap in coverage, it is recommended that you do so in the month prior to your retirement date to ensure your coverage under the TRDP begins as soon as your retirement is effective.
A two-month premium prepayment is required at the time of enrollment to ensure that you and all enrolled family members can receive benefits the first day your coverage becomes effective. Once your mandatory allotment is established, any unused portion of the prepayment will be refunded to you.
There are three ways to enroll in the TRDP: Online, Telephone or Mail. Coverage will begin on the first day of the month following the acceptance of your enrollment application and a two-month premium prepayment.
Once your enrollment is processed, you will receive a welcome packet containing your membership identification cards and Benefits Booklet. Your coverage begins the first day of the month following your enrollment, whether or not you have received your welcome packet. Your eligibility can be verified after the first of the month on the TRDP web site or by calling Customer Service.
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