The TRICARE Dental Program (TDP) is a voluntary, high-quality, cost-effective dental care benefit for eligible family members of all active duty service members as well as Reserve Component service members and/or their families. TDP is a Department of Defense (DoD) program managed by United Concordia Companies, Inc.

DFAS will provide IRS Form 1095-C to all U.S. military members, and IRS Form 1095-B to all retirees, annuitants, former spouses and all other individuals having TRICARE coverage during all or any portion of tax year 2024. An IRS Form 1095 documents you (and your family members, if applicable) have the minimum essential coverage. These forms will document the information that DFAS will provide to the IRS on yourself and your authorized family members. The forms will be required to be reported with your 2024 federal tax return. DFAS will provide you with IRS Form 1095 series forms no later than 31 January 2025.

Family members of Air National Guard Service members on Federal active duty - including current spouses and unmarried children (including stepchildren, adopted children, and wards) under the age of 21 - are eligible for enrollment in the TDP. Active duty service members are not eligible for TDP since they obtain all dental care from military dental treatment facilities. To be eligible for the TDP, the sponsor must have at least 12 months remaining on their service commitment at the time of enrollment. Unmarried children will be eligible up to the end of the month in which they turn 21, and they may be eligible after age 21 if they fit the following requirements:

Full-time Student:

A family member over age 21 may be eligible for TDP benefits through the end of the month in which turns age 23 if they are:

• Enrolled full-time at an accredited college or university

• More than 50% dependent on the sponsor for financial support

If the student terminates their education prior to turning 23, eligibility ends at the end of the month in which education terminates.

Disabling Illness or Injury:
A family member over age 21 may be eligible for TDP benefits if the family member suffered a disabling illness or disabling injury before their 21st birthday, or if they suffered a disabling illness or disabling injury between the ages of 21 and 23 while enrolled as a full-time student and more than 50% dependent on the sponsor for financial support.

The following chart provides an overview of the TDP covered services and their respective cost-shares. TDP benefits are the same for the CONUS service area as they are for the OCONUS service area.

Covered Services:
See the table below for a description of covered services and their associated cost shares:

*If your sponsor is in the Selected Reserve of the Ready Reserve and Individual Ready Reserve (IRR) or if you are in the IRR (other than special mobilization category), cost-shares for command-sponsored beneficiaries do not apply to you. Find your cost-shares using the middle two columns above based on sponsor pay grade.

**You are fully covered for space maintainers on the back teeth through age 18. Sealants are fully covered for permanent molars through age 18

*** Orthodontic treatment is available for enrolled family members:

• Children are covered up to age 21 or 23 (based on student status, learn more)

• Spouses are covered up to age 23

• National Guard/Reserve sponsors are covered up to age 23

Maximums:

The TDP limits how much can be paid per enrollee for dental services. Only the allowed fee (or the dentist's actual charge if lower) less your cost share is applied against the maximum. Services received from non-network providers do not apply toward your plan maximums. The following outlines the TDP maximum amounts:

Annual Maximum

• $1,500 per contract year for non-orthodontic services

• Payments for certain diagnostic and preventive services are not applied against the annual maximum

• In the OCONUS service area, the government pays for any valid costs in excess of the allowed amount up to the billed charge for all enrollees except Selected Reserve and IRR family members, IRR (other than special mobilization category) members, and/or those who are not command-sponsored.

Lifetime Maximum for Orthodontic Treatment

• $1,750 for orthodontic services

• Orthodontic diagnostic services are applied to the $1,500 annual maximum

Accidental Annual Maximum

• $1,200 for costs associated with dental care provided due to an accident (injury to the teeth and/or supporting hard and soft tissues from external blunt forces and not due to chewing or biting)

• After accidental maximum is met, additional costs are applied to the $1,500 annual maximum

Please view the TRICARE Dental Program Benefit Handbook for a complete list of services that do not apply to your plan maximums.

Enrollment Process:

There are three convenient enrollment options. You can call United Concordia, by mail or online. The initial premium payment is required upon enrollment. Please retain this transaction. Only sponsors-or an individual with a valid Power of Attorney can enroll active duty family members in the TRICARE Dental Program

1. Call United Concordia:

• CONUS: 844-653-4061

• OCONUS: 844-653-4060

• OCONUS TOLL: 717-888-7400

2. Mail it to United Concordia:

Download the TRICARE Dental Program Enrollment/Change Authorization document and mail it along with your initial monthly premium payment (check, money order or credit card) to United Concordia:

United Concordia
TRICARE Dental Program
P.O. Box 645547
Pittsburgh, PA 15264-5253

3. Online:

Log into the Beneficiary Web Enrollment Website. A Common Access Card or DS Logon is required to access the Beneficiary Web Enrollment Web site. Note: This option is not available overseas.

For technical assistance when using the Beneficiary Web Enrollment Web site, call the Defense Manpower Data Center at 1-800-477-8227

Premiums

TRICARE Dental Program (TDP) premiums are determined by the TDP enrollment plan (single or family) and the military status of the sponsor. For enrolled active duty family members (ADFMs), the Government assumes 60 percent of the cost of the TDP premium while participants pay 40 percent. If the military status of the sponsor changes from active duty to National Guard/Reserve, the premiums will change accordingly.

Premium Amounts
TDP premium amounts change annually on May 1st.

The following chart indicates the monthly premium responsibility as an ADFM. Premium rates will be adjusted annually on May 1.

*The Single and Family rates do not include the sponsor

The following chart indicates the as a National Guard/Reserve member and mobilized IRR service member. The Premium rates will be adjusted annually on May 1.

*The Single and Family rates do not include the sponsor

The following chart indicates the monthly premium responsibility as a non-mobilized IRR service member. Premium rates will be adjusted annually on May 1.

*The Single and Family rates do not include the sponsor

For more information, please visit the TRICARE Dental Program webpage maintained by TRICARE Management Activity:
https://tricare.mil/Dental.aspx

TRICARE Dental Program Covered Services:
https://tricare.mil/CoveredServices/Dental/TDP.aspx

TRICARE Dental Program United Concordia:
https://www.uccitdp.com/dtwdws/member/landing.xhtml

TRICARE DEERS Information:
https://tricare.mil/Plans/Eligibility/DEERS