On May 1, 2017, Tricare dental coverage for active duty, Guard and Reserve families will transition from MetLife to United Concordia.
Along with this change comes many great new benefits, but unfortunately not all dentists will be accepting United Concordia. This means you have some choices to make when it comes to your family’s dental care provider. Below are the things you need to know to make an informed decision.
Should You Drop Your Dentist if They Drop Tricare When United Concordia Takes Over?
First of all, this change only affects active duty, Guard and Reserve families. Delta Dental will continue to administer dental coverage for retirees and their families and that program is not changing at this time. For those that are part of the change, an increase in benefits and lower premiums come with the transition to United Concordia. In fact, no benefits are being reduced.
One important addition to United Concordia taking this contract is that the annual maximum benefit, which was previously $1,300 will now increase to $1,500. Under MetLife, sealants required a 20% co-pay. With United Concordia, sealants will be free.
Tricare dental is a voluntary program. You have to enroll your family if you want to use it. Previously, when a child turned 4 that was registered in DEERS, they would automatically be added to the family dental plan if that family had enrolled in one.
Under United Concordia, on the child’s 1st birthday they will be automatically added to the family dental plan. That is an important thing to consider if only a spouse was on the dental plan paying single enrollment. On the child’s 1st birthday that would automatically move the plan to a family enrollment and along with that comes a higher monthly premium.
Premiums are going down under United Concordia. You can view the chart at Tricare.mil. While premiums for some programs are going down a small amount, others will see significant savings. A single enrollment for the dependent of an active duty service member currently pays $11.68 a month, but as of May it will decrease to $11.10. That isn’t much of a savings, but an active duty family plan does have a better rate. That premium drops from $34.68 to $28.87 under United Concordia.
That’s all great, but what if the dentist you visit no longer accepts your insurance once United Concordia takes over in May?
Some dentists will no longer be accepting Tricare dental since reimbursement rates are much lower for them with United Concordia.
Dr. Adams, a dentist in Hampton Roads, Va., sees his share of military families, but says he will be losing money if he continues to do so come May. According to him, the reimbursement from United Concordia will be 15% lower than it was with MetLife.
What should you do if your dentist drops Tricare?
You can visit any dentist you want with Tricare dental, but it might cost you more. There are 330,000 network dentists with United Concordia. You can therefore, stay with your current dentist and pay out of pocket or you can search for a new dentist. You can search for a dentist online or call United Concordia customer service at 1-844-653-4061.
It is important to check if your dentist is in network. If they are not, but accept some payment from United Concordia, they might bill you for the difference in what United Concordia does not cover. Don’t get stuck with a bill. A dentist that is in network cannot bill you for any difference in payment.
Any member of your family can see any dentist; you don’t all have to go to the same practice. If there are multiple providers, you will need to check that the one you are seeing is in network. There can be several dentists in an office, each choosing to accept Tricare or not.
The dentist you choose to see may not know everything that is covered by United Concordia. You can log into your account online to see what is covered before authorizing any procedures. You will not have to file a claim if you see a dentist in network; they will do it for you.
Sticking with a dentist that is in network can save you a lot of money. Call your dentist or check online to see if they will be in the network come May.
If not, ask friends for referrals to other dentists and try someone new. If you are set on staying with your current dentist, make sure you ask how much procedures will cost before you authorize them.