TRICARE Retiree Dental Program - frequently asked Questions
1. Who's covered? People eligible to enroll in this program are:
* Members of the Uniformed Services (including the Retired Guard) who are entitled to retired pay;
* Members of the Retired Reserve who would be entitled to retired pay, but are under age 60;
* Spouses of enrolled members;
* Children of enrolled members, up to age 21 (or to age 23 for full-time students, or older if they become disabled before losing eligibility);
* The unremarried surviving spouse and eligible children of
+ a deceased member who died while eligible for coverage as described above, or
+ a deceased active duty member who died while on active duty for a period of more than 30 days and whose family members are not eligible, or are no longer eligible for dental benefits under the Family Member Dental Plan.
Those not eligible for this program are:
* Divorced former spouses of eligible members;
* Remarried surviving spouses of deceased members;
* Family members of non-enrolled retirees.
2. Are members over 65 eligible?
Yes. If you are a Uniformed Services retiree or spouse, no matter what your age, you are eligible for this program.
3. Can eligible family members enroll without the retiree?
The Department of Defense's interpretation of the current law (USC 1076c.) requires that the retiree be enrolled in order for family members to be enrolled.
4. What are the advantages of joining the program?
With the DeltaSelect USA/TRICARE Retiree Dental Program, you'll enjoy:
* Great coverage for the most commonly needed dental services to help you maintain good dental health;
* Immediate coverage, with no pre-authorizations or waiting periods required after your enrollment effective date, even for major services;
* The flexibility to visit any dentist you choose-including specialists. You and your family members can even go to different dentists if you prefer;
* The opportunity to enroll any or all of your eligible family members;
* Special advantages when you visit a DeltaSelect USA dentist, including lower out-of-pocket costs and no claims paperwork;
* The confidence of working with Delta Dental, the nation's #1 dental carrier. One in four Americans with dental coverage relies on Delta Dental for quality, affordable benefits.
5. How much does it cost?
The program is surprisingly affordable. Depending on where you live, you'll pay approximately $10-$15 a month for single person coverage, $18-$30 for two people or $31-$48 for a family of three or more.
To start enrollment, you'll need to make a prepayment of four months' premium. Once a payment process is established, the unused portion of the premium prepayment will be refunded to you approximately five months after your enrollment begins.
6. Why is a prepayment necessary?
Federal law requires the government to first attempt an automatic deduction from retired pay. A four months' prepayment ensures all eligible members will be able to participate immediately. The prepayment is used to pay the monthly premium until your payroll allotment or other payment process is established for you. Your application cannot be processed without your prepayment by check or credit card.
7. How long is the enrollment commitment?
You must enroll for an initial 24 months. After the initial 24 months, you can remain enrolled on a
month-to-month basis. Under government rules, no disenrollment is allowed during the initial 24-month commitment.
8. Which dentists can I see?
The DeltaSelect USA/TRICARE Retiree Dental Program is a preferred provider organization (PPO): a fee-for-service program in which you can go to any dentist, but there are advantages to
receiving treatment from a DeltaSelect USA dentist. DeltaSelect USA dentists have agreed to accept certain fees for covered procedures. Plus, DeltaSelect USA dentists will handle all claims paperwork for you.
If you go to an out-of-network dentist, the coverage percentage levels are the same. However, only DeltaSelect USA dentists have agreed to accept the TRICARE Retiree Dental Program fees. Therefore, you are responsible for the difference between the program payment and the amount your out-of-network dentist charges. Also, you may need to submit claim forms to collect reimbursement for out-of-network treatment.
An online dentist directory is available at web site http://www.ddpdelta.org/directory/dentdirect.html. You can also call customer service at (888) 336-3260 to request a list of participating dentists over the telephone. If you find your regular
dentist does not participate, please ask customer service representatives to send your dentist an invitation to join the network.
9. Where is coverage offered?
You can receive covered treatment anywhere in the 50 United States, District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, the Commonwealth of the Northern Mariana Islands and Canada.
10. Who administers the program?
The DeltaSelect USA/TRICARE Retiree Dental Program is administered by DDP*Delta, Delta Dental's Uniformed Services Dental Programs division, with the same high level of quality, service, and dependability delivered to you in the active duty family members' dental plan a few years ago. But the TRICARE Retiree Dental Program is unlike any other previous program, with all new benefits and guidelines.
11. What is the enrollment cutoff date?
You may enroll at any time. If your enrollment form and payment are received by the end of the month, and your eligibility can be verified, your coverage will begin on the first day of the following month.
12. Are crowns, bridges and dentures covered?
Prefabricated crowns (or caps) are pre-formed and adapted to fit your teeth. They are generally
used as an interim treatment on adults and are covered under this program. A cast crown (or cap) is laboratory processed and custom fit to your tooth. Cast crowns are not covered. Bridges and dentures are not covered at this time.
13. How many cleanings are covered?
For children, the program covers two periodic exams, two cleanings, two fluoride treatments and one set of bitewing x-rays per year. For adults, the program covers two periodic exams, one cleaning, one fluoride treatment and one set of bitewing x-rays per year.
14. Which SSN should surviving spouses use?
When enrolling, surviving spouses should submit the Social Security number of the deceased retiree rather than their own Social Security number.
15. Can my premium be deducted from VA disability pay?
At this time, only retirees whose pay comes through the Defense Finance and Accounting
Service (DFAS), Coast Guard or Public Health Service can have their premiums deducted from their retired pay. However, we will work with you to set up either the direct monthly billing or the electronic funds transfer (EFT) method of payment.
16. How do I sign up?
There are three ways to enroll:
* Enroll online at http://www.ddpdelta.org/retiree/Renrollment.html using your Visa or MasterCard;
* Enroll over the telephone with your credit card. Call between 5 a.m. and 7 p.m. Pacific Time, Monday through Friday, toll-free at (888) 838-8737;
* Download the enrollment form from this web site and return the completed form with your check, money order or credit card payment information. Mail to:
P.O. Box 537008
Sacramento, CA 95853-7008
You will receive your dental benefits kit containing your official TRICARE Retiree Dental Program identification card and Evidence of Coverage booklet by mail within two to three weeks after your enrollment is processed. Remember, your coverage begins the first day of the month following your enrollment, whether or not you have received your dental benefits kit.