TRICARE Retiree Dental Program (TRDP) Basic and Enhanced

Army Reserve: Retired

Benefit Fact Sheet

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Summary:

The TRICARE Retiree Dental Program (TRDP) Basic and Enhanced plans offer comprehensive, cost-effective dental coverage for retired Service members and their eligible Family members, for unmarried surviving Spouses and Children, and for other select individuals. The TRDP is administered by the Federal Government Programs division of Delta Dental of California under contract with the U.S. Defense Today.

Beginning in January 2016, DFAS will provide IRS Form 1095-C to all U.S. military members, and IRS Form 1095-B to all Retirees, Annuitants, former Spouses and all other individuals having TRICARE coverage during all or any portion of tax year 2015. An IRS Form 1095 documents you (and your Family members, if applicable) have the minimum essential coverage. These forms will document the information that DFAS will provide to the IRS on yourself and your authorized Family members. The forms will be required to be reported with your 2015 federal tax return. DFAS will provide you with IRS Form 1095 series forms no later than 31 January 2016.


 


 

Eligibility:

Retired Soldiers and their Family members are eligible for TRDP but must meet one of the following requirements: 

  • A Soldier (including the retired Reserve/retired National Guard) who is entitled to retired pay, including those age 65 or over.
  • A Soldier of the retired Reserve/retired National Guard who is entitled to retired pay, even if under age 60 (i.e., a "gray-area reservist, who is entitled to retired pay but does not actually begin receiving it until age 60) .
  • A current Spouse of enrolled retired member as indicated above
  • Unmarried Children of enrolled Soldiers, up to age 21 or to age 23 if a full-time student (proof of full-time student status required), or older if he or she becomes disabled before losing eligibility.
  • An un-remarried surviving Spouse or eligible Child of a deceased member who died on retired status or who died while on active duty for a period of more than 30 days and whose eligible Family members are not eligible, or are no longer eligible, for dental benefits under the active duty Family member dental plan (TRICARE Dental Program).
  • A Medal of Honor (MOH) recipient and eligible immediate Family members, or an un-remarried surviving Spouse/eligible immediate Family members of a deceased MOH recipient.
  • A current Spouse and/or eligible Child of a non-enrolled member may be eligible under the following three conditions:
    • eligible to receive ongoing comprehensive dental care from the Department of Veterans Affairs
    • Enrolled in a dental plan that is available to the member as a result of employment separate from his/her Uniformed Service, and said dental plan is not available to his/her Family members
    • Prevented from being able to obtain benefits under the enhanced TRICARE Retiree Dental Program due to a current and enduring medical or dental condition..

Note: Written documentation supporting any of these three situations above must be submitted with your enrollment application.

Former Spouses and remarried surviving Spouses are not eligible at this time.

Benefit Highlights:

The TRICARE Retiree Dental Program covers:

  • Exams, cleanings, fluorides, sealants, and x-rays
  • Fillings
  • Root canals
  • Gum surgery
  • Oral surgery and extractions
  • Crowns and dentures
  • Orthodontics

You can see a full list of benefits at www.trdp.org.

Covered Services
Coverage under the Basic TRICARE Retiree Dental Program provides the following services when visiting a participating network provider:

Types of Service

Percent of Allowed Amount

Diagnostic

100%

Preventive

80 to 100%

Restorative

80%

Endodontics

60%

Periodontics

60%

Oral Surgery

60%

Emergency Services

80%-100%

Fixed Partial Denture Sectioning

60%

Drugs

60%

Post-Surgical Services

60%

Deductible                                                           

Per patient, per benefit year

$50 (not to exceed $150 per Family)

Annual Maximum

Per patient, per benefit year

$1000

Benefit Year: 1 January - 31 December

This chart provides an overview of coverage under the Enhanced TRICARE Retiree Dental Program for patients who visit a participating network dentist.

Type of Service

Percentage of Allowed Amount

  

First 12 months of continuous enrollment

After 12 months of continuous enrollment

Diagnostic

100%

100%

Preventive

80-100%

80-100%

Restorative

80%

80%

Major Restorative

Not a benefit

50%

Endodontics

60%

60%

Periodontics

60-100%

60-100%

Prosthodontics- removable and fixed

Not a benefit

50%

Implant Services

Not a benefit

50%

Oral Surgery

60%

60%

Orthodontics

Not a benefit

50%

Emergency Services

80-100%

80-100%

Anesthesia

60%

60%

Professional Consultation

60%

60%

Professional Visits

60%

60%

Drugs

60%

60%

Post-surgical Services

60%

60%

Miscellaneous Services

60%

60%

Dental Accident

100%

100%

Deductible

Per patient, per benefit year

$50 (not to exceed $150 per Family)

Annual Maximum

Per patient, per benefit year

$1,300

Separate Dental Accident Coverage Maximum

Per patient, per benefit year

$1,200

Separate Orthodontic Maximum

Per patient, per lifetime

$1,750

Benefit Year: 1 January - 31 December

*The percentage paid by Delta is based on the allowed amount for each procedure. While the coverage percentage is the same for all TRDP patients, total out-of-pocket costs may be higher if care is received from a non-network or overseas dentist.

Service Area

TRDP Basic dental coverage is offered throughout the 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. To be eligible for reimbursement, covered services must be provided within this area, regardless of where the TRDP Basic enrollee lives. There are no overseas benefits for TRDP Basic enrollees.

Enhanced TRDP dental coverage is offered worldwide, with benefits based on primary residence. Enhanced TRDP enrollees are eligible to obtain their covered benefits within the service area described above. When traveling outside this area, Enhanced TRDP enrollees who are enrolled and living in the 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 are only eligible for emergency services overseas. (Exemption: An Enhanced TRDP enrollee's Family member who is a full-time student living overseas can receive benefits worldwide.) Enhanced TRDP enrollees are fully responsible for payment to the dentist who provided the emergency care. These enrollees will need to submit a claim form which can be downloaded at trdp.org. Delta Dental will reimburse the enrollee as applicable when the overseas emergency services claim is processed.

Enrollees in the Enhanced program who reside permanently outside the above service area may obtain the full scope of TRDP benefits anywhere in the world. If receiving care within the above service area, enrollees can receive care from a TRDP network dentist. Additional information applicable to Enhanced TRDP enrollees who reside overseas is available in the TRDP benefits booklet and on the website at trdp.org.

Enrollment Process
You have two ways to enroll-online or by mail. We strongly encourage you enroll online to get covered faster.

  • Only the sponsor (or surviving Family member) can enroll, disenroll, add, or delete Family members.
  • Look up your premium with the online premium search
    • Pay the first 2-month premium with a Visa©, MasterCard© or Discover Card©
    • Set up a monthly allotment from your retired pay. 
    • If retired pay isn't available, set up an electronic funds transfer for ongoing monthly premium payments.
  • You must enroll for a minimum of 12 consecutive months. After 12 months, you can continue on a month-to-month basis.
  • You can cancel your enrollment within 30 days as long as you haven't used any of your covered services during that time.

You can visit Delta Dental's Enroll Today page for more information:

  • Get enrollment support information
  • Watch a video about how to enroll online

Enroll Online

Enroll by Mail

Mail your TRDP Enrollment Form and premium payment to:

Delta Dental of California
Federal Government Programs
P.O. Box 537008
Sacramento, CA 95853-7008
United States of America

Please allow 10 business days from receipt to Delta Dental for processing. After that, you can verify your enrollment by registering and logging on to the Consumer Toolkit®.

Premium Rates
Federal law mandates that monthly premiums for the TRDP be deducted automatically from the retiree's pay. Premium rates for the Basic and Enhanced TRDP are based on the ZIP code in which the retiree or primary enrollee resides and the number of Family members being enrolled. Premiums for enrollees in the Enhanced-Overseas TRDP do not vary by region but are based on the enrollment option selected. Premium rates are subject to yearly adjustment on 1 October of each benefit year. To determine the exact premium rate for your region, use the online premium search or, call Delta at 1-888-838-8737.


Additional Information:

For more information, please visit:

TRICARE Retiree Dental Program webpage maintained by TRICARE:
http://www.tricare.mil/CoveredServices/Dental/TRDP.aspx

TRICARE Dental Program for Active Duty Service Members:
http://www.tricare.mil/addp

TRICARE DEERS Information:
http://www.tricare.mil/DEERS 

TRICARE Retiree Dental Program webpage maintained by Delta Dental:
http://www.trdp.org/

TRICARE Retiree Dental Program Fact Sheet:
http://www.trdp.org/downloads/fact-sheet-general.pdf

TRICARE Retiree Dental Program Benefits Booklet
http://www.trdp.org/downloads/benefits-booklet.pdf

 

 

Document Review Date: 30 March 2016