How do I find out if Tricare Prime covers braces?

Question

I call them and there dumb about it, i just want to know does it depend on what denist you go to? or what?

Answer 1

Dental insurance is different from Tricare.  The military dental is through United Concordia and if you have subscribed to it, the active duty member's LES will show the  premium being paid each pay day.  If you have not enrolled, you should as no dental is covered by Tricare.

If you have enrolled, Concordia will cover the cost of braces up to the yearly cap...$1500 per person.  That is all they will pay...period.  My daughters braces cost over $5500.00.  Out of that, our cost share was nearly $4000, which we were able to pay off in montly installments (most dentists do have payment plans available for braces).  The only time you may be able to get braces with no cost to you is if you are stationed overseas where there is no option to use off base providers.

Answer 2

Here's the link that covers the basics about orthodontics. And it doesn't matter if your Prime or not, the Tricare Dental Program is United Concordia and you have to be enrolled separately since monthly premiums are taken out of the active duty member's pay.

http://www.tricaredentalprogram.com/tdpt...

Answer 3

Tricare Prime does not cover dental. You need to ask United Concordia (Tricare Dental Plan). I can't remember off the top of my head what percentage (if any) they do cover.

Answer 4

Tricare doesn't cover ANY dental unless as a result of traumatic injury.  United Concordia is the dental insurance, and has a monthly fee.  Braces are only covered for dependents under 18, not spouses.  and there is a cap of like $1500 total.  

Answer 5

easily they don't! for dental u have to go through united concordia and they don't cover braces either i tried already.

Answer 6

They do not cover things like that, because those are optional and not necessary.

Answer 7

Tricare Prime only covers dental care that is adjunctive - "Dental care which is medically necessary in the treatment of an otherwise covered medical (not dental) condition, is an integral part of the treatment of such medical condition and is essential to the control of the primary medical condition; or, is 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 (iatrogenic)."

If you are enrolled in Tricare Dental Program, then your orthodontic care can be covered as described below (from the Tricare Dental Program Handbook starting on page 55)  http://tricare.mil/mybenefit/Download/Fo...

"Orthodontic treatment is available for family

members (non-spouse) up to, but not including,

21 years of age. Family members who are

enrolled full time at an accredited college or

university are eligible up to, but not including,

23 years of age. Orthodontic treatment is also

available for spouses and National Guard/Reserve

members up to, but not including, 23 years of

age. (In all cases, coverage is effective until the

end of the month in which the member reaches

the applicable age limit.) Enrollment should be

verified with United Concordia prior to receiving

any care."

In general, if you are over 23 you are probably out of luck.