WHAT'S COVERED

The following chart provides an overview of the TDP covered services and their respective cost-shares. TDP benefits are the same for the CONUS service area as they are for the OCONUS service area.

Please note: The TDP provides selected services including endodontic, periodontic, and oral surgery at a reduced cost-share for enrollees who are grades E-1 to E-4. For more detailed information about the TDP covered services, see the TRICARE Dental Program Benefit Booklet. 

Maximum Benefits

MaximumAmount
Annual Benefit Maximum $1,500 per enrollee
Orthodontic Lifetime Maximum (See age limitations in Orthodontics Section below) $1,750 per enrollee
Dental Accident Coverage Annual Maximum $1,200 per enrollee

Your Cost-Share

Covered ServicesCONUS Service AreaOCONUS Service Area
Pay Grades
E-1 - E-4
Pay Grades
E-5 and above
Command-Sponsored
Beneficiaries1
Diagnostic
  • Exams - 2 in a consecutive 12-month period by same provider. Additional exam covered by different provider
  • Periodontal evaluation - 1 in a consecutive 12-month period, per office
  • Full mouth x-ray (complete series or panoramic x-ray) - 1 in 36 months
  • Bitewing X-rays - 1 in a consecutive 12-month period
0% 0% 0%
Preventive2
  • Cleanings - 2 in a consecutive 12-month period. 3rd cleaning is allowed for pregnant patients and patients diagnosed with diabetes, coronary artery disease (heart), cerebral vascular disease (stroke), rheumatoid arthritis, lupus, oral cancer and recipients of an organ transplant.
  • Topical fluoride treatments – 2 in a consecutive 12-month period
  • Space maintainers under age 19
0% 0% 0%
Emergency Services
  • Emergency treatment of dental pain
0% 0% 0%
Sealants
  • Sealants on permanent molars through age 18
0% 0% 0%
Consultation/Office Visit
  • Diagnostic consultation by additional dentist
  • Office visit after regular hours
20% 20% 0%
Post-Surgical Services 20% 20% 0%
Basic Restorative
  • Fillings (amalgam and resin)
  • Resin-based composite crowns on anterior (front) teeth – 1 in a consecutive 12-month period.
  • Prefabricated resin crowns – once per tooth per lifetime on anterior primary teeth, anterior permanent teeth through age 14 or as result of accidental injury.
  • Prefabricated stainless steel crowns with resin windows – once per tooth per lifetime. On primary anterior and premolar teeth to any age, on permanent anterior and premolar teeth through age 14.
20% 20% 0%
Endodontic 30% 40% 0%
Periodontic
  • Surgical and non-surgical periodontic services
  • Additional benefits for enrollees with a qualifying medical condition
  • Periodontal scaling and root planing – 1 in 24 months for each area of the mouth
  • Crown lengthening – once per tooth, per lifetime
30% 40% 0%
Oral Surgery 30% 40% 0%
General Anesthesia 40% 40% 0%
Intravenous Sedation 50% 50% 0%
Miscellaneous Services (occlusal guard, athletic mouth guard) 50% 50% 0%
Other Restorative
  • Crowns, onlays, buildups and posts and cores – 1 in 5 years
50% 50% 50%
Implant Services 50% 50% 50%
Prosthodontic
  • Fixed and removable prosthetics
50% 50% 50%
Orthodontic 50% 50% 50%
Medications 50% 50% 0%
  1. OCONUS cost shares only apply to command-sponsored enrollees receiving care in OCONUS service areas. These cost shares do not apply Selected Reserve (Sel Res) and Individual Ready Reserve (IRR) family members and IRR (other than special mobilization category) members. Beneficiaries in this category and/or non-command sponsored members are subject to CONUS cost-share arrangements as noted in the middle two columns above.

  2. Space maintainers for posterior teeth for patients under age 19 are fully covered.

  3. Orthodontic treatment is covered for the following enrolled family members:

    • Children up to age 21 or 23, based on student status

    • Spouses up to age 23

    • National Guard/Reserve sponsors up to age 23

YOUR DENTAL PLAN INCLUDES TDP WELLNESS PROGRAM

Improved benefits for people with certain chronic medical conditions and gum disease

If you or an enrolled family member has been diagnosed with a chronic illness and periodontitis (gum disease), TDP Wellness Program is available to provide additional dental benefits at no cost to you. Getting the proper treatment and maintenance for gum disease will have a positive effect on your overall wellness as scientists continue to uncover connections between certain chronic conditions and gum disease.

TDP Wellness Program is for people with the following chronic medical conditions:

  • Cerebral Vascular Disease (stroke)

  • Coronary Artery Disease (heart)

  • Diabetes

  • Lupus

  • Oral Cancer

  • Organ Transplant

  • Rheumatoid Arthritis

  • Pregnancy (additional, third cleaning in a consecutive 12-month period, only)

 

Register to use TDP Wellness Program any time after your insurance plan’s effective date. Here’s how:

  • Visit uccitdp.com

  • Sign into My Account using your DS Login

  • Click Manage My Wellness

  • Add your medical condition

With TDP Wellness Program you’ll get full coverage for periodontal services, including surgical procedures, to remove the financial obstacles to total oral care.

Improved Benefits

ServiceCoverage
Periodontal maintenance – an additional service per year 100%*
Scaling and root planing 100%*
Periodontal surgery – four procedures** 100%*

* Standard frequency limitations apply

** Four procedures related to gingival flap or osseous surgeries

The program also includes email outreach designed to educate and encourage you to stay on track with your oral care to better manage your condition. You can request to receive regular monthly emails full of tips to keep you aware of the importance of oral health.