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Col. Alexander Alex, Air Force Reserve Command health benefits manager.
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From the Tricare Advisor: Tricare Dental Program announces changes
Posted 7/24/2012 Updated 7/24/2012
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by Lt. Col. Alexander Alex
Air Force Reserve Command
7/24/2012 - Citizen Airman/Aug 2012 -- The Department of Defense has contracted with Metropolitan Life Insurance Co. to provide services under the Tricare Dental Program, which is a voluntary, premium-based dental insurance plan. MetLife will provide services for enrollment, claims processing and customer support.
While the change occurred in May, it's a good time to highlight the dental program benefits as there have been a few changes.
You are eligible for the Tricare Dental Program if you are a family member of a Reservist or a Reserve member on active duty such as a spouse or eligible dependent child who does not qualify for Tricare Young Adult.
Reserve members (Individual Ready Reserve or Selected Reserve of the Ready Reserve) who are on active-duty orders for more than 30 consecutive days or covered by the Transitional Assistance Management Program after serving on active duty for more than 30 consecutive days in support of a contingency operation are covered by the Tricare Active Duty Dental Program, which is different than the MetLife program.
The new contract provides some enhancements to your benefits. Changes include the following:
* Coverage of tooth-colored/white fillings on back teeth.
* An increased annual maximum benefit from $1,200 to $1,300 per enrollee.
* An increase in the orthodontic lifetime maximum from $1,500 to $1,750 per enrollee.
* $1,200 per year for services related to dental treatment due to an accident.
* No cost-shares for scaling and root planing (deep cleaning) for diabetics.
* The benefit year under MetLife will run from May 1 to April 30 (annual maximums).
Premium rates under the new MetLife contract are lower for each enrollee category. If your premiums are automatically deducted from your military payroll account, you will see the new, lower deduction on your April leave-and-earnings statement. The following lists your TDP monthly premium rates for dental coverage effective May 1 to Jan. 31, 2013. Beginning Feb. 1, 2013, the premium year will return to the February 1-January 31 cycle. Premium rates will reset annually every Feb. 1.
* Active-Duty Family Members: Single, $10.30/month; and family, $30.89/month
* Selected Reserve, IRR (Mobilization Only) and Family Members: Sponsor only, $10.30/month; single, $25.74/month; family, $77.22/month; and sponsor and family, $87.52/month
* IRR (Non-Mobilization) and Family Members: Sponsor only, $25.74/month; single, $25.74/month; family, $77.22/month; and sponsor and family, $102.96/month.
Similar to Tricare Reserve Select, the Tricare Dental Program offers worldwide coverage with two service areas.
The continental United States service area includes the 50 states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. The outside continental United States service area includes Canada, all other countries, island masses and territorial waters, as well as civilian ships or vessels outside the territorial waters of the continental United States service area, regardless of the dentist office address.
Dental Coverage
The Tricare Dental Program offers comprehensive dental coverage, which includes:
* Diagnostic and preventive services (exams, cleanings, fluorides, sealants and X-rays).
* Basic restorative services (fillings, including tooth-colored [white] fillings on back teeth).
* Endodontics (root canals).
* Periodontics (gum surgery).
* Oral surgery (tooth extractions).
* Prosthodontics (crowns, dentures).
* Orthodontics (braces).
* Scaling and root planning (deep cleaning) for diabetics at no cost.
If you have the TDP, it's recommended that you and/or your family members register online at https://employeedental. metlife.com/dental/public/EmpEntry.do to create your own "Dental Benefits" account with secure features that allow you to:
* View plan coverage details.
* Check a claim.
* View claims history.
* View explanation of benefits.
* Access tools and resources.
* Access the "Find a Dentist" feature.
* File a grievance.
Additionally, once signed in, you can view frequently asked questions and oral health information, and download commonly used forms/documents, the Tricare Dental Program Benefit Booklet and other materials. A DOD self-service log-on is required.
This log-on can be easily created if you possess a Common Access Card and does not require access to a government computer or CAC card reader. This action can be accomplished from any computer.
(Anyone who has a question regarding a benefit as it relates to a Reserve member or family beneficiary member may email the Tricare advisor at alexander.alex@us.af.mil.) |
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