Does TRICARE cover braces and orthodontics?
Quick Answer
The TRICARE Dental Program covers orthodontics for dependent children under 21 (or 23 for students). Coverage includes braces with a lifetime maximum of $1,750. Active duty orthodontics are available at MTFs based on readiness needs.
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Key Takeaways
- TDP covers orthodontics for dependents under 21 (or 23 for students)
- 50% cost-share with a lifetime maximum of approximately $1,750
- 12-month waiting period after TDP enrollment for orthodontic benefits
- Active duty can get braces at MTFs based on readiness needs
Detailed Answer
Orthodontic coverage under TRICARE is available through the TRICARE Dental Program (TDP) for eligible dependents, with specific rules and limitations.
TDP Orthodontic Coverage for Dependents
- Available for dependent children enrolled in TDP
- Coverage for children under age 21 (or 23 if full-time student)
- Includes braces, retainers, and related orthodontic treatment
- 50% cost-share (TRICARE pays 50%, you pay 50%)
- Lifetime maximum benefit of approximately $1,750 per person
What Is Covered
- Initial orthodontic evaluation and treatment planning
- Traditional metal braces
- Ceramic braces
- Retainers after active treatment
- Periodic adjustment visits
- X-rays and models needed for treatment
What Is NOT Covered
- Clear aligners (such as Invisalign) are generally not covered
- Cosmetic-only orthodontics without functional need
- Treatment for adults (dependent spouses) is limited
- Orthodontics for active duty members through TDP
Active Duty Orthodontic Care
- Available at some Military Treatment Facilities (MTFs)
- Based on military readiness needs, not cosmetic
- Significant malocclusion or functional problems may qualify
- Long wait lists are common at most MTFs
- Free if provided through the military dental system
Enrollment in TDP
- TDP is a separate enrollment from TRICARE medical
- Monthly premiums apply for TDP coverage
- Enrollment is through United Concordia (current TDP administrator)
- 12-month waiting period for orthodontic benefits after enrollment
Cost-Saving Tips
- Compare orthodontist fees before starting treatment
- Ask about payment plans for your 50% portion
- Consider treatment at a dental school for reduced costs
- Ensure your orthodontist is in the TDP network for maximum benefits
Retiree Dependents
- Retiree family members are not eligible for TDP
- FEDVIP dental plans may offer orthodontic coverage
- Compare FEDVIP plans that include orthodontic benefits during Open Season
Helpful Tips
- Enroll in TDP at least 12 months before your child needs braces to clear the waiting period
- Use an in-network orthodontist to maximize your TDP benefits
- Ask about payment plans from your orthodontist for the portion you owe
Related TRICARE Terms
Related Questions
Does TRICARE cover my family members?
Yes, TRICARE covers eligible family members including spouses, children under 21 (or 23 if students), and children with disabilities.
Does TRICARE cover dental care?
TRICARE medical plans include limited dental (emergency only). Separate dental insurance available through FEDVIP program.
How does full-time student status affect TRICARE eligibility?
Full-time students can remain on TRICARE until age 23 instead of 21, provided they maintain full-time enrollment at an accredited institution.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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