TRICARE Dental Options ATTENTION PRESENTER: To ensure that TRICARE beneficiaries receive the most up-to-date information about their health benefits, you must visit www.tricare.mil/briefings for the latest version of all briefings before each presentation. Briefings are continuously updated as benefit changes occur. Presenter Tips: Review briefing with notes prior to your presentation. Ensure “slide show” setting. Remove any slides that do not apply to your audience. Estimated Briefing Time: 20 minutes TRICARE Resources: Visit www.tricare.mil/publications to view, print, or download copies of TRICARE educational materials. Suggested resources include: Active Duty Dental Program brochure, Dental Options fact sheet, Costs and Fees sheet, and TRICARE Plans overview. Briefing Objectives: Increase awareness and understanding of TRICARE dental benefits. Discuss how to enroll in TRICARE dental options and get dental care. Provide additional resources for more information. Optional Presenter Comments: Welcome to the TRICARE Dental Options briefing. The goal of today’s presentation is to give you a general understanding of your TRICARE dental benefits.

TRICARE Dental Options: Today’s Agenda Today, we will discuss how to update your information in the Defense Enrollment Eligibility Reporting System, or DEERS, and how to get dental benefits through the Active Duty Dental Program, the TRICARE Dental Program, and the TRICARE Retiree Dental Program. We will review the overseas dental options. Finally, we will talk about the difference between medical and non-medical dental services and provide you with contact information if you have any additional questions.

TRICARE Eligibility: Updating DEERS Optional Presenter Comment: First we will discuss keeping information in DEERS up to date.

Keep DEERS Up To Date Once you and your family are registered in DEERS, be sure to keep addresses and other contact information up to date for all family members. Keeping DEERS information current, especially your address, is critical to ensuring uninterrupted TRICARE coverage for you and your family. While only the sponsor can add family members in DEERS, both the sponsor and family members 18 years and older can update contact information. Anytime there is a change in family status (marriage, birth, adoption, divorce, death, etc.), the sponsor must update DEERS. Promptly update your information when any change occurs, regardless of whether or not you are on active duty at the time. You can update your DEERS information online, by phone, by mail, or by fax. Update your information online through the milConnect website listed. MilConnect is the Defense Manpower Data Center’s online portal that gives you access to your information in DEERS. For more information about how to access milConnect, visit https://myaccess.dmdc.osd.mil. If you prefer to update your information in person, you can visit an ID card-issuing facility. To locate one, visit the link provided on the screen. For more information, go to www.tricare.mil/deers. Note: Be sure to register newborn or newly adopted children in DEERS within 60 days of birth or adoption. Prompt registration of children in DEERS can minimize delays or problems with coverage and claims processing.

TRICARE Dental Options: Active Duty Dental Program Optional Presenter Comment: Now we will discuss the Active Duty Dental Program.

Dental Options: Active Duty Dental Program Active duty service members, including National Guard and Reserve members called or ordered to active service for more than 30 consecutive days, automatically receive TRICARE dental benefits. If you live or work within 50 miles of a military dental treatment facility, or DTF, you must seek care from a military dentist. Visit your base website or check with your command unit to find a dental clinic. The Active Duty Dental Program, or ADDP, provides civilian dental care to service members who are unable to receive the care they need from a military dental clinic. The ADDP is available in the United States and U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands). Administered by United Concordia Companies, Inc. (United Concordia), the ADDP is available to service members who: Receive referrals from military DTFs, or Live and work more than 50 miles from a base with a military DTF. It is your responsibility to ensure that you are properly coded as “Remote” in DEERS, if necessary. You should work with your unit to make changes in DEERS. Note: If you live or work within 50 miles of a military DTF and seek civilian dental care without a referral, you may be responsible for the entire bill. In addition, if you live remotely, you must have an Appointment Control Number, or ACN, to make an appointment. We’ll talk about ACNs next.

Dental Options: Getting Care Through ADDP To get care through the ADDP, you will need an ACN from United Concordia. If you are referred by a military dentist, he or she should give you a Referral Request Confirmation with the ACN. The number is only valid for the service specified in the referral confirmation, so make sure to get another referral if you need additional services. Remember, no matter where you live, private-sector dental care is not authorized until an ACN is provided by United Concordia, except in cases of dental emergency. If you live in a remote location, you can fill out an online Appointment Control Number Request Form to get an Appointment Control Number. The form is available on the ADDP website. Once you have an ACN, there are three ways to make an appointment through the ADDP: If you have a military dentist, you can have him or her make the appointment for you. You can contact an ADDP Dental Care Finder to set an appointment for you. Or, you can schedule the appointment yourself. To schedule your own appointment, note your network dentist on your Appointment Control Number Request Form. You must select a network dentist, which is a dentist who has a contract with United Concordia to perform services at negotiated rates. You can find a list of network dentists on the ADDP website. Note: Activated Reserve members who are in the early-enrollment period and who live within 50 miles of a DTF can still access dental care with a civilian dentist with an ACN. It is not required to go to a DTF first.

TRICARE Dental Options: TRICARE Dental Program Optional Presenter Comment: Now we will discuss the TRICARE Dental Program.

Dental Options: TRICARE Dental Options Eligible beneficiaries can enroll in the TRICARE Dental Program, or TDP, a voluntary, premium-based DoD program. The benefit is administered by United Concordia. The program is available to: Active duty family members Selected Reserve and Individual Ready Reserve members and their families Transitional survivors Surviving family members The program is available in both CONUS and OCONUS locations. The TDP CONUS service area includes the 50 United States, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. The TDP OCONUS service area includes areas not in the CONUS service area and covered services provided on a ship or vessel outside the territorial waters of the CONUS service area. Command sponsorship for OCONUS coverage is not required, but costs are higher for OCONUS enrollees who are not command sponsored.

Dental Options: Enrolling in TDP You can enroll in the TRICARE Dental Program online, by mail or by phone. To get an enrollment form, visit the Beneficiary Web Enrollment, or BWE, portal. Your initial premium payment is required with enrollment. You can use a credit card to make your premium payment. Or, if enrolling by mail, you can send the first month’s premium payment by personal check, cashier’s check, traveler’s check, money order or credit card. Each month's premium payment covers the following month’s dental care. There is a 12-month minimum enrollment period for most beneficiaries. Exceptions include: Beneficiaries who lose eligibility Enrollees who are relocated OCONUS or to an area where there is space-available care at a military dental treatment facility National Guard and Reserve members who are called or ordered to active service for more than 30 consecutive days Note: National Guard or Reserve members enrolled in the TDP will be disenrolled if called or ordered to active service for more than 30 consecutive days. Once deactivated, you will be automatically reenrolled. Family members will remain enrolled and pay a reduced premium rate while the sponsor is on active duty.

Dental Options: TDP Covered Services and Cost-Shares The chart shows some of your cost-shares for services received when you have TDP coverage. Note: For details on TDP covered services, visit www.uccitdp.com, click on “Benefits” and then “What’s Covered?” for details. A cost-share is the percentage of the allowable charge you will pay for covered services. For example, if United Concordia’s allowance for a basic filling in the United States was $100, you would be responsible for 20 percent of that amount, or $20. Note: A cost-share is not determined by the dentist’s charge, but the amount United Concordia has agreed to. If you use a network dentist, TDP will pay the full amount for preventive and diagnostic services, which generally include your two check-ups and cleanings in a 12-month period. You can find a network dentist on the United Concordia website. Contact information is at the end of this briefing. If you use a non-network dentist, you will be responsible for the difference between United Concordia's allowance and the dentist's charge in addition to any applicable cost-shares. Network dentists in the CONUS service area are available in the 50 United States, District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. Note: We’ll talk about OCONUS dental options a little later in the briefing. Certain services have cost-shares based on the sponsor’s pay grade. The annual maximum coverage per enrollee is $1,500. After reaching the annual maximum, you will be responsible for 100 percent of United Concordia's negotiated rate for all covered services.

Dental Options: TDP Payment Information To pay for TDP, the first premium must be paid by personal check, cashier’s check, traveler’s check, money order or credit card. You can make ongoing premium payments through payroll allotment. If payroll deduction is available, then this will be the method of payment. If payroll allotment is not available, monthly premiums may be paid by electronic funds transfer or recurring credit card payment. Members must ensure that premium payment amounts are being collected accurately while enrolled to avoid being disenrolled for failure to pay premiums For information about costs, visit www.tricare.mil/costs.

TRICARE Dental Options: TRICARE Retiree Dental Program Optional Presenter Comment: Now we will discuss the TRICARE Retiree Dental Program.

Dental Options: TRICARE Retiree Dental Program The TRICARE Retiree Dental Program, or TRDP, is a voluntary, premium-based DoD program. The benefit is administered by Delta Dental of California. It is available to retired service members and their families, retired National Guard and Reserve members and their families, Medal of Honor recipients and their families, and eligible survivors. In general, if you are entitled to retired pay, you are eligible for the TRDP. This includes National Guard and Reserve members in the “gray area” who are entitled to retired pay but do not begin receiving payments until age 60. The TRDP offers covered services worldwide. The service area for enrollees in TRDP includes the United States and the U.S. territories (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands), and Canada. The Overseas TRDP is available to eligible beneficiaries outside of the TRDP service area. For more information about the Overseas TRDP, visit the TRDP website at www.trdp.org and type "Overseas Care" into the search bar.

Dental Options: Enrolling in TRDP You can enroll in the TRICARE Retiree Dental Program online or by mail. To enroll online, visit the TRDP website and connect to the Beneficiary Web Enrollment website. To get an enrollment form, visit the TRDP website. You will need a Discover, Visa or MasterCard to enroll online. You must be showing in the DEERS system as a retiree. Because of documentation requirements, family-member-only applicants must enroll by mail. There is a 12-month minimum enrollment period for most beneficiaries. If there are circumstances that prevent you from accessing TRDP benefits, you may voluntarily disenroll with approval from Delta Dental. For beneficiaries enrolling effective Jan. 1, 2018, the 12-month lock-in period is waived due to the upcoming transition of the TRDP to the Federal Employees Dental and Vision Insurance Program (FEDVIP). Note: Two months premium payment due at time of enrollment. Enrollment within four months after retirement allows access to the full benefit. Enrollments after this period will have only a limited benefit for the first 12-months. Enrollments effective Jan. 1, 2018 will only receive the limited benefit under the TRDP contract, prior to the switchover to FEDVIP.

Dental Options: TRDP Covered Services and Stateside Cost-Shares This chart indicates your cost-shares for TRDP-covered services. TRDP will cover the services in the top section of the chart for all enrollees upon initial enrollment. This includes preventive and diagnostic services, such as your twice-yearly check-ups and cleanings, as well as coverage for root canals, oral surgery, gum surgery and dental accidents. The section titled “Additional Services” includes the services covered when you enroll in TRDP within four months after retirement or after you have been enrolled in TRDP for 12 consecutive months. These services include crowns, dentures, dental implants, and braces. Enrollments effective Jan. 1, 2018 will only receive the limited benefit under the TRDP contract, prior to the switchover to FEDVIP. There is a deductible and coverage maximum for each enrollment year, which runs from January 1 through December 31. The deductible is $50 per enrollee with a $150 family cap. The annual maximum is $1,300 per enrollee with an additional maximum of $1,200 for dental accident services. What the program pays out for cleanings, exams and X-ray does not count against your $1,300 annual maximum. After you reach the maximum, you will be responsible for the full cost of dental services for the rest of the enrollment year. Like the TRICARE Dental Program, coverage amounts cannot be accrued, rolled over, or transferred among family members. The lifetime maximum benefit for enrollees receiving orthodontic services is $1,750 per enrollee. Adults, as well as children, have an orthodontic benefit in the TRDP. The information provided is for services received from network providers through the TRDP. To find a network dentist, visit the TRDP website.

Dental Options: TRDP Payment Information To pay for the TRDP, a two-month premium prepayment by Visa, MasterCard, or Discover card; personal or cashier’s check; or money order is required. Monthly payments are automatically made by allotment through military retired pay. If retired pay is unavailable/insufficient, monthly payments are made by electronic funds transfer or recurring credit card charges. Note: Monthly premium amounts for TRDP enrollees will vary depending on where you live and the number of family members you elect to enroll. To find the most up-to-date cost information, visit www.tricare.mil/costs. Dental care under the TRDP will transition to FEDVIP effective Jan. 1, 2019. This transition will offer beneficiaries a wide choice of dental insurance carriers to choose from, with varied benefits.

TRICARE Dental Options: Overseas Dental Options Optional Presenter Comment: Now we will discuss overseas dental options.

Dental Options: Overseas Dental Options Now let’s discuss dental options for personnel stationed overseas. Most overseas active duty service members, or ADSMs, receive dental care at military overseas dental treatment facilities, or ODTFs. Keep in mind that civilian dental care is not available overseas for ADSMs assigned to ODTFs. The TRICARE Dental Program, or TDP, is a voluntary, premium-based DoD program. The benefit, administered by United Concordia, is available worldwide for: Active duty family members Selected Reserve and Individual Ready Reserve members and their family members Survivors qualifying for the TDP Survivor Benefit For retirees, dental care is provided by the Overseas TRICARE Retiree Dental Program, or TRDP, administered by Delta Dental of California. Overseas TRDP is a voluntary dental-insurance program available to: Retired service members and their eligible dependents Retired National Guard and Reserve members and their families Certain qualifying survivors Medal of Honor recipients and their immediate family members and survivors For ADSMs in remote overseas locations, International SOS Government Services, Inc. coordinates dental care services.

Other Important Benefit Information Optional Presenter Comment: Now we will discuss other important benefit information.

Medical v. Non-Medical Services It is important to know which dental conditions are covered by your dental insurance and which are covered by your medical benefit. Adjunctive services are medical conditions that are not covered by the TDP, but may be covered by your TRICARE medical insurance. Adjunctive dental care is dental care that is: Medically necessary in the treatment of an otherwise-covered medical (not dental) condition An integral part of the treatment of such a medical condition Essential to the control of the primary medical condition Required in preparation for, or as the result of, dental trauma, which may be or is caused by medically necessary treatment of an injury or disease An example of an adjunctive service would be the removal of teeth in order to treat facial trauma resulting from an accidental injury. The TRICARE Dental Program does not cover services that are adjunctive dental care. Please contact your regional medical contractor for coverage details. These are medical services that may be covered under TRICARE’s medical benefit, even when provided by a general dentist or oral surgeon. For coverage details, contact your TRICARE medical regional contractor.

Today’s Agenda: For Information and Assistance Optional Presenter Comment: The next two slides provide contact information that may be useful to you while using TRICARE dental options.

For Information and Assistance In summary, active duty service members automatically receive TRICARE dental benefits. Other eligible beneficiaries can choose to enroll in the TRICARE Dental Program or TRICARE Retiree Dental Program, depending on your beneficiary status. Here are some important resources to help you better understand your dental benefits.

Looking for More Information? This slide shows contact information for stateside and overseas regional contractors, as well as other important information sources. Remember, your regional contractor is based on where you live.