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 Services division of Delta Dental of California. Additional legislation in 2000 allowed the program to include comprehensive coverage. The Department of Defense awarded Delta Dental the current contract, effective May 1, 2003, to continue administering the program for the next five years.
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 either the basic program (group #4600), which offers coverage for basic and preventive services, or in the enhanced program (group #4601), which offers a full scope of benefits including orthodontics and dental accident coverage. New enrollments in the TRDP are limited to the enhanced program.
The TRDP is supported by both the Delta Dental PPO and Delta Dental Select national networks. While enrollees have the option to see any licensed dentist in the service area, they are encouraged to seek care from a dentist in one of these networks.
Covered services under the 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.
Covered Services at a Glance
| Benefits available during the first 12 months of enrollment:
|
*Delta Dental Pays |
|
Basic
(group #4600) |
|
| Diagnostic services |
100% |
100% |
Preventive services
|
80-100% |
80-100% |
| Basic Restorative services 1 |
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% |
| Partial/Full Dentures |
NAB |
50% |
| Orthodontics 2 |
NAB |
50% |
| Deductibles & Maximums |
|
Annual Deductible per Patient 3 |
$50 4 |
$50 4 |
| Annual Maximum per Patient 5 |
$1000 |
$1200 |
| Orthodontic Maximum per Patient |
NAB |
$1200 |
| Dental Accident Maximum per Patient |
NAB |
$1000 |
Benefit Year: May 1- April 30
NAB = Not a Benefit
1 Amalgam allowance for posterior composites for enhanced program only.
2 Children and adults are eligible for Orthodontics.
3 Does not apply to diagnostic and preventive services covered at 100%, orthodontics, or dental accident coverage.
4 Family deductible limit of $150.
5 Does not apply to diagnostic and preventive services covered at 100%.
|
Claims Information
TRDP claims should be sent to:
Delta Dental of California
Federal Services
PO Box 537007
Sacramento, CA 95853-7007
It is important that all claims be submitted using the retiree’s (sponsor) social security number. Special claim forms are not required. Claims may be submitted electronically or by mail
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. TRDP benefit payments are not assignable. |
