Kathy Roskosky Central TRICARE Service Center (CTSC) TRICARE Dental Program (TDP)

Slides:



Advertisements
Similar presentations
Dental Administration 101
Advertisements

Delta Dental of New Mexico Oral Health is Our Passion Quality Benefits, Quality Dentists … administering the dental program for State of New Mexico General.
TRICARE Dental Program (TDP) 1 LD# L [exp0513]
Module 3: TRICARE Options. 2 Module Objectives After this module, you should be able to: Describe some of the key features of the TRICARE Standard, Extra,
Guard & Reserve Healthcare in the Pacific Territories Issues and Solutions.
Questions? Ohio Army National Guard State TRICARE Coordinator SSG Tiffany Miller at x1778,
TRICARE PROGRAM Everything you need to know Kathy Roskosky Central TRICARE Service Center (CTSC)
1 TRICARE Your Military Health Plan Overview of TRICARE Benefits for National Guard, Reserve Component Members and their families BR400801BEN0504C.
TRICARE Retiree Dental Program. Introduction TRDP established: February 1, 1998 –Basic Program TRDP Enhanced: October 1, 2000 –Enhanced Program.
Remote Active Duty Service Members TRICARE Active Duty Dental Program Training FOR THE AUDIO PORTION Please dial toll free: Access Code:
Overview of 2014 Dental Benefits provided to Retiree groups by Delta Dental of California.
Flexible Benefits Delta Dental. February APRIL 2010 Dental Plans – Delta Dental New! Effective January 1, 2013, Delta Dental will be replacing.
Welcome to Your Texas A&M System Dental Benefits Program.
Delta Dental of New Mexico  Oral Health is Our Passion Quality Benefits, Quality Dentists … administering the dental program for State of New Mexico.
Garden Grove Unified School District
Waldemar Pustul Deputy Director, Remote Site Health Care TRICARE Area Office – Europe.
Fairleigh Dickinson University Webinar Effective Date – January 1, 2010.

Central TRICARE Service Center
Module 5: National Guard and Reserve. 2 Module Objectives After this module, you should be able to: Explain TRICARE coverage for National Guard/Reserve.
Overview of 2014 Dental Benefits provided to Classified by Delta Dental of California.
1 Accessing Care & Providers How do I Get an Appointment?
2010 UBO/UBU Conference Title: How to: MSA Billing Session: M
TRICARE Active Duty Dental Program (ADDP) for Remote Care Effective 1 August 2009 Contact ASC Surgeon’s Office with questions at or
Offered Exclusively Through Seniors Choice is the premier group retiree medical plan for employees and retirees age 65+ which originates where Medicare.
Basic Dental Insurance Coding and Billing
Brunssum Dental Care Lt Col E F Murphy RADC BDS DPDS MFGDP(UK) MFDSRCPS(Glas) Regional Senior Dental Officer (Germany) Defence Primary Health Care Brunssum.
Health Related Discounts Medical Care The NYU Student Health Center offers employees a number of medical services: evaluation and treatment of minor work-related.
As of 8/17/ Guard/Reserve TRICARE Continuum of Coverage Speaker: Mr. Sanders TRICARE Regional Office - South.
CHAPTER © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in.
Insurance Handbook for the Medical Office
Evaluation of the TRICARE Program FY 2011 WHAT IS TRICARE? TRICARE is a family of health plans for MHS. TRICARE responds to the challenge of maintaining.
Module 11: Dental. Module Objectives After this module, you should be able to: Describe the Active Duty Dental Program (ADDP) Explain the TRICARE Dental.
Health Insurance.
Lesson Objectives TRICARE Dental Program After this lesson, you should be able to: Explain what the TRICARE Dental Program is and who can enroll in it.
Dental Insurance United Concordia. February APRIL 2010 Dental Insurance  Eligibility is determined based on where an employee lives.  Regular.
TRICARE Your Military Health Plan 1 PP411BEC11063W Introduction to TRICARE Presented by: 6 Medical Support Squadron Beneficiary Counseling and Assistance.
Delta Dental of New Mexico  Oral Health is Our Passion Quality Benefits, Quality Dentists … administering the dental program for State of New Mexico.
Module 11: Dental. 2 Module Objectives After this module, you should be able to: Explain the purpose of the Active Duty Dental Program Describe eligibility.
1 AARP Dental Insurance Plan Serving the individual dental insurance needs of the 50+ population Dr. Lowell Daun.
Module 3: TRICARE Options. 2 Module Objectives After this module, you should be able to: List the features of TRICARE Standard, Extra and Prime Explain.
CHAPTER © 2012 The McGraw-Hill Companies, Inc. All rights reserved. 12 TRICARE and CHAMPVA.
State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield.
Overview of Dental Benefits 2014 by Delta Dental of California – Certificated Teachers.
TRICARE Your Military Health Plan 1 Transitioning from Active Duty to Retirement Fort Lee Pre-Retirement Seminar 25 February 2011 PP4121BET03095W Version.
Chapter 14 TRICARE and CHAMPVA Elsevier items and derived items © 2010, 2008 by Saunders, an imprint of Elsevier Inc.
1 TRICARE Retiree Dental Program USCG Retiree Council April 27, 2010.
Module 8: Other Activities. 2 Module Objectives After this module, you should be able to: List some of the key features of TRICARE Plus Explain the ECHO.
Chapter 14 TRICARE and CHAMPVA Elsevier items and derived items © 2010, 2008 by Saunders, an imprint of Elsevier Inc.
Overview of Dental Benefits by Delta Dental of California – Salinas Education Center Certificated.
Module 3: TRICARE Options. 2 Module Objectives After this module, you should be able to: List the differences between TRICARE Standard, Extra, and Prime.
1 Military Dental Treatment Facility TRICARE Active Duty Dental Program Training.
Anderson University Employee Benefits Presentation January, 2016.
Module 11: Dental. 2 Module Objectives After this module, you should be able to: Describe the Active Duty Dental Program Explain the TRICARE Dental Program.
Module 3: TRICARE Options
Module 4: TRICARE Prime Remote. 2 Module Objectives After this module, you should be able to: Describe some of the key features of TRICARE Prime Remote.
TRICARE Retiree Dental Program trdp.org TRICARE Retiree Dental Program ®
1 Active Duty Dental Plan (ADDP) Remote Dental Care & Reserve Health Readiness Program (RHRP) Dental Screening Overview.
Chapter 10 Military Carriers.
Take Command Thank you for having me with you today.
TRICARE Costs: Supplemental Briefing Slides That Provide Additional Information to the Other TRICARE Briefings ATTENTION PRESENTER: This set of slides.
TRICARE Dental Options
BRIEF PLAN OVERVIEW FOR JULY 1, 2018 – June 30, 2019
TRICARE Select ATTENTION PRESENTER: To ensure that those with TRICARE get the most up-to-date information about their health benefit, you must go to
TRICARE Costs: Supplemental Briefing Slides That Provide Additional Information to the Other TRICARE Briefings ATTENTION PRESENTER: This set of slides.
Welcome to Your Texas A&M System Dental Benefits Program
TRICARE PRIME REMOTE CARING FOR OUR SOLDIERS’ HEALTH 11/24/2018.
TRICARE® Dental Options: An Overview of Your TRICARE Dental Options
ENLISTED ADVANCEMENT REVIEW COURSE e4-e7
Welcome to Your Texas A&M System Dental Benefits Program
Presentation transcript:

Kathy Roskosky Central TRICARE Service Center (CTSC) TRICARE Dental Program (TDP)

United Concordia Companies Inc. (UCCI) is the contractor Multiple Initiatives occurring –Verification Process and TRDP coming OCONUS OCONUS Non-Availability and Referral Forms (NARF)s Host Nation Provider Designations TRICARE Global Remote Overseas (TGRO)

TRICARE Dental Program (TDP) New Contract began 1 Feb Implants were a new benefit Non-availability and Referral Forms (NARF)s are needed for orthodontics and implants in both remote and non-remote countries NARFs for both comprehensive orthodontic treatment and for dental implants are given to beneficiaries after a review and approval of the treatment plan by the TAO-Europe Dental Office

TRICARE Dental Program (TDP) TDP came overseas in 1999 Currently we are seeing increased usage of the TDP due to more demand for family member dental care, and less capacity in the military clinics to meet those treatment needs TDP Overseas benefits are better than the stateside benefits – patient cost shares are paid, amount over the maximum allowable charges are paid, 50% versus $1500 paid for orthodontic benefit

TRICARE TDP OCONUS Sponsors must be enrolled in the TDP for family members to utilize the dental insurance program Premiums - Single family members - $12.12 per month, multiple family members - $30.29 per month The TDP CONUS and OCONUS administered by United Concordia Companies Inc. (UCCI) TDP enrollees are eligible for care worldwide: - At OCONUS Dental Treatment Facilities and with listed OCONUS civilian providers - Civilian providers in the United States Must be command sponsored for OCONUS benefit

TDP OCONUS Cost Shares $1200 annual maximum benefit for non-orthodontic care per enrollee per contract year (1 Feb- 31 Jan) $1500 maximum lifetime orthodontic benefit - Eligibility for orthodontic benefits are for children up to age 21, full time students and spouses up to age 23 Sponsor/family members are responsible for non-covered services and charges over the maximum benefit

TDP OCONUS Cost Shares Restorative, Endodontics, Periodontics & Oral Surgery Services – TDP pays 100% of billed charge - Government pays cost shares Other Restorative (onlays, crowns, bridges), Prosthodontics, and Implants - UCCI pays 50% up to yearly maximum of $1200 The government pays amounts that are above the maximum allowable charge Orthodontics - UCCI and the Government pay 50% of the total cost OCONUS

TRICARE OCONUS Preferred Dentists TMA has issued a contract to SAIC making them responsible for certification of providers and for finding providers who will file claims with UCCI Providers who will file claims directly with the insurance company, UCCI, will be designated as Preferred Dentists The contract to do this took effect in Aug We are already trying to find providers who will file the claims directly with the insurance provider - UCCI Preferred Dentists will be so designated at the TDP web site – currently we have 130 listed “Preferred Dentists”

TRICARE OCONUS Verified Dentists A verified dentist is a dentist who has been visited by dental clinic personnel or SAIC representatives and they have had a TMA dental criteria sheet completed and on file They have had the claim filing proposition discussed with them, but they have elected to continue to have the patients pay for care at the time of service and then patients file the claim Verified dentists will be listed at the TAO web site, but not as “Preferred Dentists”

Host Nation Provider Criteria Host Nation Providers must meet certain criteria before being designated as a Preferred or a Verified Dentist: Must speak English Must be a graduate of a dental school Must be licensed in their country Wear mask and gloves when treating patients Must sterilize their instruments Must meet 15 other clinical requirements

TRICARE Dental Program Facts Approximately 55% of eligible family members in overseas locations are enrolled in the TDP Of this 55% only about 20% of these enrollees utilize the program in any given year Younger or lower ranking members tend to have lower enrollment rates than NCOs and Officers 81% of the claims filed from OCONUS locations are filed by the dental provider for the patient Overseas claims makeup only 3% of the total

TRICARE Global Remote Overseas (TGRO) Locations In Remote OCONUS locations Active Duty Members should contact International SOS when they are in need of dental treatment Treatment under $500 is approved by and paid by International SOS Treatment costing over $500 must have a treatment plan and radiographs sent to ISOS, treatment is then reviewed and approved by TAO-E – ISOS then guarantees payment TGRO Family members should utilize the TDP

TRICARE Retiree Dental Program (TRDP) A new TRDP contract was awarded to Delta Dental Plans and began on 1 Oct 2008 As a part of this contract, the TRDP was extended to overseas areas on 1 Oct 2008 Specifics of the Enhanced Overseas TRDP are available at the web site or toll free at then dial www.trpd.org TRDP premiums are neither subsidized by the government nor are patient cost shares paid by the government

TMA Dental Initiatives As of 1 July 2009 European AOR active duty members in the US on leave or on TDY will be covered for urgent or emergent care by the Active Duty Dental Program (ADDP). Contact UCCI for appointments or information. The Enhanced Overseas TRICARE Retiree Dental Program began – Oct 2008 TMA Contract to Verify providers and to find Preferred Dentists – Began in Sept 2008

TRICARE Dental Program (TDP) Dental insurance program that utilizes host nation dentists to supplement or replace care that is not available in Military Dental Clinics We are seeing increased usage of the TDP Military clinics are giving 35-40% of their available care to family members TRICARE Retiree Dental Program Numerous organizations involved in OCONUS dental care – UCCI, DDP, ISOS, SAIC, TCMP