The Military Guide

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Military Dental Care

by Doug Nordman

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Military Dental Care is one of the subjects that didn’t fit well into the book (at least not the first edition!), but it could be a significant part of some veterans’ budgets.

Active-duty servicemembers don’t even have to think about dental care because it’s provided by their military treatment facility. However families, Reservists/National Guard*, and retirees have to either purchase insurance or pay their own way.

TRICARE’s many dental plans go well beyond the scope of this post for their coverage of certain beneficiaries and other specialized procedures– see the links for each plan if your situation isn’t discussed here.

Military Dental Care – Tricare Dental Plan

The TRICARE Dental Plan is for everyone except retirees. It covers preventive care and routine dental care (up to $1200/year) at a cost-effective premium. It also covers fillings, root canals, crowns, and periodontal care under a cost-share plan. In early 2011, premiums for active-duty families range from $12.69-$31.72/month. Premiums for Reserve/Guard families are the same, but if the sponsor is added to the policy then premiums rise to $79-$111/month.

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Many Reserve/NG attempt to go “family only” without their own dental insurance, expecting to get their care during periods of active duty.* Unfortunately if they’re mobilized on short notice then they may need extensive work before they’re cleared for overseas (or even some CONUS) duty. The decision to go without insurance could have long-term readiness impacts for short-term savings. It could also be literally very painful!

The TDP also covers the first $1500 of orthodontia. This is not always worth the cost of the premiums, especially for the children of retired sponsors and Reserve/NG. Many periodontists will discount their services by almost that amount (especially considering the cost of paying the insurance premiums) for an up-front payment– or even for not having to file an insurance claim. When your pediatric dentist suggests orthodontia for your kid(s) then read the policy’s fine print, do the math, and see if you can negotiate a discount with the orthodontist. If you expect to bring the orthodontist a whole family of business then ask for a group discount.

The TRICARE Retiree Dental Program is for retirees, their families, their survivors, and even for retired “gray area” Reserve/NG who have not yet started receiving their pension. Premiums vary by region, so bring your ZIP code to the TRDP premium calculator.  In early 2011 the premium range swings from $29-$48/month for one retiree to $95-$156/month for a family of three and up.

The TRDP’s coverage seems confusingly complex and retirees have to do the math for their particular situation. Diagnostic and preventive services are covered at 100% with no copay. However fillings are only 80% covered and more significant procedures (root canals, crowns) are only 60% covered. Even worse, the significant procedures require a $50/year deductible and are limited to $1000/year in benefits. (Apparently this is different from a $0 deductible and $950/year benefits!) Orthodontia is not even covered by this policy.

It’s human nature to be skeptical or even cynical about complicated insurance policies, and this one may not be worth the cost. Even the cheapest individual coverage, $29/month, may exceed the cost of paying for your own semi-annual diagnostic/preventive services. If your dental clinic learns that you’re paying the bill then they may discount their fees substantially below the premium rates. Even at the lowest cost of $29/month you’re paying $348/year in premiums to insure against the possibility of needing an extra $602 of care. It doesn’t take long to put enough money in a savings account to self-insure against this risk.

If you’re genetically blessed with great teeth and gums (never a cavity or periodontia) then you may not need retiree dental insurance. If you have fillings or earlier gum problems but have developed strict brushing/flossing habits and use a fluoride rinse, then you may not want this insurance. Even if you’re not genetically blessed or not very strict in your habits, you may want to consider delaying coverage until your dentist warns you of signs of impending trouble. (You can still save a lot of your money by developing those brushing & flossing habits!)  If you’ve already had periodontia or a couple of root canals or crowns, and you’re not feeling confident about the future, then this insurance may be worth the cost.  For those who would rather do anything else than visit the dentist, talk with yours about stretching out the interval between visits. They may be willing to do an annual exam (with x-rays) and biennial cleanings. Your dental health is partly a function of your family genetics, but your initiative and motivation can affect at least half of the savings.

In addition to TRICARE’s dental plans, the Veteran’s Administration offers dental treatment to some veterans. This is mainly limited to those who have service-connected disabilities considered 100% disabling, or service-connected dental disabilities. However the VA covers several niche categories of dental care (such as former POWs) and under some circumstances may even offer one-time treatment to recently discharged veterans. The VA’s eligibility criteria are listed here.

So how did our Nords family navigate this labyrinth of coverage over the last 30 years? My spouse and I both started out on active duty with “free” benefits. When our daughter had the teeth and age to qualify for coverage, we insured her. When my spouse joined the Reserves she continued her excellent dental hygiene and used space-available diagnostic/preventive services* when she was on active duty. On the day I retired, we did the math and canceled our daughter’s insurance. When the billing agent for our pediatric dentist discovered that we were paying cash, she let out a “Woo-hoo!!” and discounted our fee by 20%. We were also able to negotiate a substantial discount with the orthodontist that saved about the same as the cost of the insurance premiums and the coverage limits, only with much less paperwork.

It personally took me nine fillings and some gum issues to develop good dental hygiene habits, but my last “restorative procedure” was over 30 years ago and I’m comfortable going without insurance. I’m definitely uncomfortable around dentists, so I visit mine every 24-30 months for bite-wing or panoramic x-rays along with an exam and minor cleaning. However I’m still alert to the possibility that someday I may need a root canal or even a crown, and that motivates me to keep things clean.

* I’ve heard stories of Reservists/NG getting free dental exams during their drill weekend or their active duty. If your unit has the time and you find a friendly dentist at the local MTF then it doesn’t hurt to ask! Your XO will appreciate your efforts to raise the unit’s dental readiness statistics.

If you’d like to share a military dental care “lesson learned” or “after-action report”, then please post a comment, use the “Contact” box, or send me an e-mail!

Related articles:
Six months before retirement…
Medical and dental exams
Reserves/Guard: Tricare Reserve Select and Tricare Retired Reserve health insurance
During retirement: Healthy lifestyle
Will Congress change military retirement?

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