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FAQs: Enrollees >> Frequently Asked Questions
1. Who is eligible for the TRDP? Those eligible to enroll in the TRDP are:
Retired Uniformed Services members and their families who meet the above criteria and who live outside the designated TRDP service area are eligible to enroll in the Enhanced-Overseas Program for comprehensive coverage worldwide. Those not eligible for the TRDP are:
2. Can family members enroll without the retiree? Yes, in certain cases. In most circumstances, the retiree must be enrolled in the TRDP in order for family members to enroll; however, expanded eligibility criteria as amended in Title 10 of the U.S. Code, Section 702, Public Law 105-261 allow for a spouse and/or eligible family member(s) of a retired Uniformed Services member to enroll if the retiree chooses not to enroll and is:
If a retiree meets any one of the above three criteria and wishes to enroll a family member, the following documentation must be submitted with the enrollment form, as applicable:
3. How much does the TRDP cost? The TRDP is designed especially to provide Uniformed Services retirees and their families with optimum dental coverage at an affordable cost. Premium rates for the TRDP vary depending on the region in which the primary enrollee resides and the enrollment option selected (single, two-person or family enrollment of three or more persons). To start enrollment, applicants are required to make a prepayment of two months of premiums.
Enrollees in the Enhanced Program can find the current premium rates for the TRDP on this web site. The contract to administer the TRDP requires premium rates to be adjusted slightly each contract year (October 1 through September 30). Department of Defense-directed implementation of further program enhancements could result in the contractual establishment of premium rate changes from those for the current contract year. Also, an enrollee’s monthly premium rate may change if he or she moves or changes the enrollment option. Premium rates for enrollees in the Enhanced-Overseas Program are equivalent to those for Region C of the Enhanced Program. 4. Why is a two-month premium prepayment required with enrollment? The premium prepayment is necessary to ensure there is no lapse in coverage while the mandated retired pay allotment or other applicable billing method is being established for the enrollee. Once a payment process is established, any unused portion of the premium prepayment will be refunded, usually during the third month of enrollment.
5. How do I pay my monthly premiums? The contract with the Department of Defense to administer the TRDP requires monthly premiums to be collected automatically through retired pay deduction. At this time, only retirees whose retired pay is processed through the Defense Finance and Accounting Service (DFAS), Coast Guard or Public Health Service will have their premiums deducted from their pay. However, we can work with enrollees to set up an alternative payment method if retired pay is not available or is insufficient to allow the allotment (such enrollees can include unremarried surviving spouses/children, retirees receiving VA disability pay, or those in Retired Reserve status who are under age 60). 6. What is the TRDP service area? The TRDP service area for enrollees in the Enhanced Program includes the 50 United States and the District of Columbia, as well as Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, the Commonwealth of the Northern Mariana Islands and Canada. Enhanced Program enrollees are eligible for coverage of emergency services when traveling outside this area (an exception is made for certain enrolled dependents who are studying abroad). Enrollees in the TRDP whose primary residence is outside this area may enroll in the Enhanced-Overseas TRDP for worldwide coverage. 7. Do I have to see a network dentist to get covered benefits under the TRDP? No. The TRDP is a combined fee-for-service/preferred provider plan. This means that TRDP enrollees have the ability to seek treatment from any licensed dentist they choose who practices within the service area, regardless of whether or not he or she is a participating TRDP network dentist. Although there are some advantages to having treatment provided by a participating network dentist, the TRDP does not limit access to dental care by requiring that enrollees seek treatment only from a dentist who belongs to the network that serves the TRDP. Delta Dental does not maintain a dentist network outside the designated TRDP service area. Enrollees in the Enhanced-Overseas Program, as well as Enhanced Program enrollees who are seeking treatment for dental emergencies when traveling overseas, can check the international online overseas host nation provider search tool or call Delta Dental's international dentist referral service for a referral to an overseas dentist. 8. What are the advantages of seeing a network dentist? Enrollees will save more on out-of-pocket expenses by seeing a dentist who participates in the networks that serve the TRDP. These participating network dentists have agreed to pre-negotiated fees and to submit all claims paperwork for TRDP patients. With a non-network dentist, reimbursement for TRDP covered services is not based upon a schedule of pre-negotiated fees. Seeing a non-network dentist can mean higher out-of-pocket costs for enrollees, and they may have to submit their own claims paperwork. TRDP enrollees also have the option of seeing a Delta Dental Premier® dentist for some of the same advantages as a participating TRDP network dentist. Although Delta Dental Premier® dentists do not belong to the networks that serve the TRDP, they will submit TRDP claims for the patient, accept payment for TRDP services directly from Delta Dental, and abide by Delta Dental's quality-of-care standards. In addition, Delta Dental Premier® network dentists will not charge TRDP patients more than the fees they have agreed upon with Delta Dental; however, TRDP patients will still be responsible for applicable copayments and deductibles as well as any difference in the agreed-upon fees and the TRDP allowable fee for covered services provided by non-network dentists. 9. How can I find a list of network dentists near me? A list of network dentist offices is readily available through our online dentist directory. You may also call our toll-free automatic Interactive Voice Response (IVR) line to request a list of network dentists in your area. If you already have a dentist who does not belong to the TRDP network, please let us know. We will be happy to send him or her an invitation to join the network of dentists who serve the TRDP. 10. What is meant by a “deductible” and an “annual maximum amount”? A deductible s the dollar amount that a patient must pay toward certain covered services before the TRDP can determine payment of a claim for those services. The deductible amount under the TRDP is $50.00 per enrollee per contract year, with a $150 cap per family per contract year. The annual maximum amount (also called the maximum allowable amount) is the total amount per enrollee per contract year that Delta Dental will pay toward the enrollee’s TRDP covered services. The annual maximum amount allowed by the TRDP for most covered procedures is $1,200 per enrollee per contract year. The deductible and maximum amounts restart on October 1 of each contract year. 11. Are major services like crowns, bridges, dentures and orthodontics covered? Yes. Coverage for such major services as cast crowns, bridges, onlays, partial/full dentures and even dental implants is available after 12 months of continuous enrollment in the TRDP. Orthodontics for both children and adults is also available after the 12-month waiting period has been satisfied. Retirees who enroll within four months after their retirement from active duty or transfer to Retired Reserve status may be eligible to skip the initial 12-month waiting period for coverage of all these additional services available under the TRDP if they can provide appropriate documentation (retirement orders, Chronological History of Drill Points, etc.) to support their waiver request. 12. What does the term “coordination of benefits” mean? When you have coverage under two dental programs, most carriers cooperate with one another to allow you to make use of both programs--often paying 100 percent of your dental bill. This is called “coordination of benefits” (COB). The dental industry has developed rules for coordinating benefits to help carriers make sure their enrollees will be able to get the maximum benefit for reasonable and necessary dental care. Although coordination of benefits can often pay most or all of your dental bill, COB rules help avoid duplicate payments and overpayments--such as payment for four cleanings instead of the two that most carriers pay for--which can ultimately result in higher costs for dental care. You can greatly benefit by having coverage under two dental programs. If you are enrolled in the TRDP and then get a job that offers dental benefits, we recommend that you ask your other coverage carrier about their policy on COB to ensure that you are able to get the maximum coverage under both plans. You can also find out more about coordination of benefits in the online Benefits Booklet. If after reviewing your other carrier’s COB policy you decide to disenroll from the TRDP, remember that enrollment in the TRDP requires an initial enrollment commitment of 12 months. If you do not exercise your option to disenroll from the TRDP during your 30-day enrollment grace period, you must complete the 12-month commitment before you can disenroll, even if you get other dental coverage in the meantime. 13. How long is the enrollment commitment? Enrollees in the TRDP must commit to an initial enrollment period of 12 months. Once the 12-month enrollment commitment has been satisfied, enrollment can continue on a month-to-month basis. 14. When can I enroll in the TRDP? You may enroll in the TRDP at any time—there is no specific or limited “open enrollment” period. If we receive your enrollment form and premium prepayment by the end of any month, your coverage begins on the first day of the following month. 15. How do I enroll in the TRDP? There are three ways to enroll in the TRDP: Online, by telephone or by mail. You will receive your dental benefits Welcome Packet containing your TRDP identification cards and Benefits Booklet after your enrollment is processed. Remember that your coverage begins the first day of the month following your enrollment, whether or not you have received your welcome materials. In addition to a Benefits Booklet and program identification cards, enrollees in the Enhanced-Overseas TRDP will receive a supplement in their Welcome Packet that provides details on guidelines that apply specifically to the overseas program. |
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