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TRICARE Retiree Dental Program

TRICARE Retiree Dental Program. Introduction. TRDP established: February 1, 1998 Basic Program TRDP Enhanced: October 1, 2000 Enhanced Program TRDP contract renewed: May 1, 2003 Improved features New TRDP contract: Oct 1, 2008 Added benefits Enhanced-Overseas Program. Service Area.

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TRICARE Retiree Dental Program

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  1. TRICARE Retiree Dental Program

  2. Introduction • TRDP established: February 1, 1998 • Basic Program • TRDP Enhanced: October 1, 2000 • Enhanced Program • TRDP contract renewed: May 1, 2003 • Improved features • New TRDP contract: Oct 1, 2008 • Added benefits • Enhanced-Overseas Program

  3. Service Area • TRDP coverage is offered worldwide: • Basic Program • The 50 United States & District of Columbia, Puerto Rico, Guam, U.S. Virgin Islands, American Samoa, Commonwealth of the Northern Mariana Islands, and Canada • Enhanced Program • All the above, plus coverage for emergency services overseas • Enhanced-Overseas Program • Coverage available worldwide

  4. Eligibility • Those eligible to enroll in the TRDP are: • Members of the Uniformed Services who are entitled to retired pay, including those age 65 and over • Members of the National Guard/Reserve who are in Retired Reserve status, regardless of age • Current spouses and eligible children of enrolled members

  5. Eligibility • Those eligible to enroll in the TRDP are: • Unremarried surviving spouses & eligible children of deceased members who died while in retired or active duty status • Current spouses and eligible children of non-enrolled members, under limited circumstances • Medal of Honor recipients and their eligible immediate family members

  6. Enrollment • Enhanced program enrollment classifications: • New enrollee • 12-month waiting period for major services • New retiree (4 months) • no waiting period for major services • Medal of Honor recipients • no waiting period for major services

  7. Enrollment • TRDP enrollment process • Three ways to enroll: • Online, phone or mail • Retiree submits application and premium prepayment • New retirees must submit documentation for credit toward the 12-month waiting period

  8. Enrollment • TRDP enrollment process (continued): • Enrollment commitment • Initial 12-month commitment • Continuing month-to-month • 30-day grace period • Delta Dental processes application • Coverage begins the first day of the month following acceptance of the enrollment application • Welcome packet (e-packet available)

  9. Premiums • Premiums vary by region • 5 premium regions based on ZIP code • Monthly premiums for 10/1/12 - 9/30/13 • Enhanced Program • Single: $32.01 - $51.81 • Two Person: $61.92 - $99.87 • Family (3 or more): $103.23 - $167.34

  10. Premiums • Billing • Mandatory automatic deduction from retired pay • Direct billing • Premium prepayment • Two-month prepayment required upon enrollment • Refund

  11. Program Features • Expansive dentist network, over 184,155 nationwide • Benefit year - Oct 1 through Sep 30 • Annual maximum • $1,200 • Deductible • $50 ($150 family cap) • Dental accident coverage • $1000 • Coordination of Benefits

  12. Covered Services • Preventive & diagnostic • 100% • Basic restorative • 80% • Endodontic, periodontic & oral surgery • 60%

  13. Additional Covered Services Additional Covered Services After 12 Months • Dental implants, cast crowns & onlays • 50% • Bridges & partial/full dentures • 50% • Orthodontics • 50%

  14. Orthodontics • Orthodontics • Subject to a 12-month waiting period • Not subject to annual deductible • Separate $1,500 lifetime maximum • Coverage for both children and adults • Coverage for treatment in progress

  15. TRDP Network Dentists • More cost savings, best value • Accept the “allowed fee” as the maximum billing fee for covered services • Charge only the applicable estimated copayment at the time of service • Submit your claim to Delta Dental at no charge • Two cleanings, two exams and one x-ray in a 12-month period with no copayment • Enhanced Programs only

  16. TRDP Network Dentists

  17. TRDP Network Dentists • Finding a TRDP network dentist • Search from over 184,155 dentist locations via our online dentist directory • trdp.org • Call Customer Service • 888-838-8737 • Ask your dentist

  18. Non-TRDP Network Dentists • Non-TRDP Network Delta Dental dentists • Includes Delta Dental Premier® • You pay any difference between the allowed amount and the Delta Dental Premier® dentist’s fee on file • Other Licensed Dentists • Bill you their normal fees and you pay the difference • Most likely is higher than allowed amount • May not submit paperwork for you • Responsible for full payment upfront

  19. TRDP Resources • Website • trdp.org • Marketing Representatives

  20. Questions?

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