Costs
In addition to monthly premiums, you'll pay cost shares for covered dental services. Cost shares will vary depending on the sponsor's pay grade and your service area: CONUS or OCONUS.
|
Covered Services |
CONUS Service Area | OCONUS Service Area | |
|
Pay Grades |
Pay Grades |
Command-Sponsored Beneficiaries1 |
|
|
Diagnostic |
0% |
0% |
0% |
|
Preventive2 |
0% |
0% |
0% |
|
Sealants |
20% |
20% |
0% |
|
Consultation/ |
20% |
20% |
0% |
|
Post-Surgical Services |
20% |
20% |
0% |
|
Basic Restorative |
20% |
20% |
0% |
|
Endodontic |
30% |
40% |
0% |
|
Periodontic |
30% |
40% |
0% |
|
Oral Surgery |
30% |
40% |
0% |
|
General Anesthesia |
40% |
40% |
0% |
|
Intravenous Sedation |
50% |
50% |
0% |
|
Miscellaneous Services(occlusal guard, athletic mouth guard) |
50% |
50% |
0% |
|
Other Restorative |
50% |
50% |
50% |
|
Implant Services |
50% |
50% |
50% |
|
Prosthodontic |
50% |
50% |
50% |
|
Orthodontic3 |
50% |
50% |
50% |
- The cost shares for OCONUS command-sponsored beneficiaries do not apply to Selected Reserve and IRR family members and IRR (other than Special Mobilization Category) members. Beneficiaries in this category are subject to CONUS cost share arrangement as noted in the two middle columns.
- Space maintainers are fully covered for patients under age 19 when involving posterior teeth. They are covered at a 20% cost share for patients under age 19 when replacing anterior teeth only. Sealants are covered at 20% as noted above.
- 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
Dental coverage is subject to specific limitations and exclusions. Please refer to the TRICARE Dental Program Benefit Booklet for a description of covered services, schedule of benefits payable, limitations and exclusions.
Last Modified:April 19, 2012
