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Do I have dental coverage?

TRICARE offers a voluntary dental insurance program called the TRICARE Retiree Dental Program (TRDP). Delta Dental is the claims processor for the TRDP dental claims and all enrollment, claims and coverage questions should be directed to them.      

The TRDP is available to retired service members and their eligible family members, including retired National Guard and Reserve members who are entitled to retirement pay but will not begin receiving it until age 60 and their eligible family members. The TRDP is also available to certain surviving family members of deceased active duty sponsors, and Medal of Honor recipients and their immediate family members and survivors. For information about the TRDP and to enroll, please visit www.trdp.org or call Delta Dental of California at 1-888-838-8737. 

TRICARE breaks dental care into two major categories:

Routine and Adjunctive Dental Care

See below for a description of the Routine and Adjunctive Dental Care, along with a description of the Oral Surgery Benefits.

Routine Dental Care

Covers cleaning, preventative dental care, bridge work, Orthodontia, root canal, cavities, dental emergencies and dentures.   

Routine dental care is not a covered service under your TRICARE For Life medical benefit. For information about the TRDP and to enroll, please visit www.trdp.org or call Delta Dental of California at 1-888-838-8737. 

Adjunctive Dental Care 

Adjunctive Dental Care is 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). Under limited circumstances, the TRICARE For Life medical benefit may cover only when it is a necessary part of other medical care that is covered. 

There are certain oral surgical procedures that are performed by both physicians and dentists, and that are essentially medical rather than dental care.  For the purpose of TRICARE For Life, the following procedures whether performed by a physician or dentist, are considered to be in this category and benefits may be extended for otherwise covered services and supplies:

  1. Excision of tumors and cysts of the jaws, cheeks, lips, tongue, and roof and floor of the mouth, when such conditions require a pathological examination.
  2. Surgical procedures required to correct accidental injuries of the jaws, cheeks, lips, tongue, and roof and floor of the mouth.
  3. Treatment of oral or facial cancer.
  4. Treatment of fractures of facial bones.
  5. External (extra-oral) incision and drainage of cellulitis.  (Inflammation of the skin.)
  6. Surgery of accessory sinuses, salivary glands, or ducts.
  7. Reduction of dislocations and excision of the temporomandibular joints, when surgery is a necessary part of the reduction.
  8. Any oral surgical procedure that falls within the cosmetic, reconstructive, or plastic surgery definition is subject to preauthorization guidelines.