The Preferred PPO covers Concordia Orthodontic coverage for adults, and Flex dental plans from United Concordia cover orthodontic care. These insurance policies pay 50% of the cost of orthodontic care, up to a lifetime maximum of $1,750. Up to the age of 19, both adults and children are eligible for this coverage. These insurance plans may pay for braces and clear aligners as orthodontic treatments.
It is significant to note that, unless specifically stated otherwise, these plans do not cover dentists who are not in their network. This means that your insurance may not pay the full cost of your treatment if you decide to go to a dentist not a part of the UNITED CONCORDIA TRICARE DENTAL network. It would help if you located a dentist in United Concordia’s network to guarantee you get the most out of your dental insurance.
Concordia orthodontic coverage for adults plans
Flex and Preferred are the two PPO plans that Concordia orthodontic coverage for adults offers. Both plans provide a typical preventive incentive provision, and all covered Class I services are deductible-free. The Flex plan has an annual maximum, whereas the Preferred plan is a conventional PPO.
In some of United Concordia’s Flex and Preferred PPO plans, clear aligners and braces may be covered by orthodontic coverage. Through United Concordia, the Smile for Health® Value PPO Plan 1 is likewise accessible.
United Concordia Flex and preferred PPO plan comparison
Flex and Preferred are the two PPO plans that Concordia orthodontic coverage for adults offers. The Flex plan has an annual maximum, whereas the Preferred plan is a conventional PPO. Both programs have a preventive incentive that is included with every plan and waives the deductible for all Class I services that are covered.
The Concordia Flex Passive PPO plan offers the same in-network and out-of-network percentages and a wide range of designs and options that can be customized to meet any group’s needs.
One of the top providers of dental insurance in 2023 is United Concordia.
Concordia orthodontic coverage cost
Concordia orthodontic coverage for adults is priced according to several variables, including the type of procedure and the dentist’s fees. Up to the $1,750 Lifetime Orthodontic Maximum (OLM), the TDP will pay 50% of United Concordia’s allowance. On the United Concordia FEDVIP website, the Cost Estimator option offers estimated price ranges for suggested dental procedures.
Thousands of dollars can reduce the cost of future care with early identification and treatment. Please get in touch with United Concordia’s customer service department toll-free at 1-866-357-3304 or visit their website if you have any queries about your dental plan.
Does Tricare cover braces for adults?
Yes, under some circumstances, TRICARE will pay for adult braces. Concordia orthodontic coverage for adults only reimburses orthodontics if they are related to treating a serious congenital disability and are deemed to be proven medically necessary.
Therefore, Concordia orthodontic coverage for adults will pay for the braces cost if an adult’s braces are considered medically essential for addressing a serious congenital defect.
To determine if a particular case qualifies for coverage, it is advised to speak with a TRICARE provider. Each enrollee is only eligible for a maximum annual benefit of $1,500 for orthodontic care.
Tricare covers orthodontic braces for eligible beneficiaries if they are needed to treat a serious congenital defect. The Tricare Dental Program covers orthodontic care for National Guard and Reserve sponsors, all spouses up to age 23, and children up to age 21.
Additionally, up to 50% of the cost of clear dental aligners and orthodontic services are covered. However, because orthodontia does not meet the criteria for general medical needs, Concordia orthodontic coverage for adults does not cover it.
Does Tricare cover braces for spouses?
Under certain circumstances, Concordia orthodontic coverage for adults will pay for braces for spouses of active duty service members. The Concordia orthodontic coverage for adults TRICARE Dental Program’s (TDP) eligibility requirements state that “spouses of active duty or National Guard and Reserve sponsors under age 23” can enroll.
This indicates that a spouse of an active duty service member younger than 23 qualifies for TDP coverage, which covers braces similarly to regular coverage.
For spouses and kids, the Concordia orthodontic coverage for adults provides coverage for orthodontic procedures, including braces. However, maximum benefits exist, such as a $1,500 annual benefits cap per enrollee and a $ 1,750 lifetime cap per enrollee for orthodontic treatment.
It is significant to remember that some services of Concordia orthodontic coverage for adults may be subject to additional restrictions or limitations, and some services may be excluded. A Service must also be deemed medically necessary, appropriate, reasonable, and adequate for the condition to qualify for coverage.
Does Tricare cover braces for dependents?
For members of the U.S. Armed Forces in active duty or retirement, as well as their dependents, Concordia orthodontic coverage for adults provides health and dental benefits. Tricare pays for orthodontic treatment, including braces, for some qualified family members.
Children up to age 21 or 23, depending on their status as students, spouses up to age 23, and National Guard/Reserve sponsors up to age 23, are all family members eligible for orthodontic treatment. If orthodontic care is deemed medically necessary and proven, Tricare will cover it.
The Tricare Dental Program (TDP), a dental plan offered by Tricare, includes Concordia orthodontic coverage for adults and other dental services. The TDP covers traditional braces as well as clear aligners like Invisalign.
The coverage type and the individual’s eligibility determine the TDP’s cost. When the sponsor is on active duty, the cost for single dependent coverage is $11.60 per month, and the price for family coverage is $30.15 per month. The initial premium payment is necessary when enrolling and can be made by calling United Concordia.
Tricare dependent coverage expires at age 21 (or 23 if enrolled full-time in college), it is essential to note. Military dependents can purchase the Tricare Young Adult (TYA) plan, which has a premium structure for coverage up to age 26.
FAQ for Concordia orthodontic coverage for adults
At what age do you stop getting braces for free?
Under Tricare, beneficiaries must be 21 years old to receive free braces or 23 if they are full-time students. Clear teeth aligners and orthodontic services cover up to 50% of the cost, and spouses are covered up to age 23.
Will the military pay for braces? Orthodontics and crooked teeth
For National Guard and Reserve sponsors, all wives up to age 23, and children up to age 21 (or 23 if enrolled as a full-time student), orthodontic care is covered through the TRICARE Dental Program. Dental insurance, which pays up to 50% of the price of braces, may be available to some TRICARE beneficiaries. Only braces determined to be medically required by a doctor are covered.
Does Tricare pay for retainers?
Retainers are covered by the TRICARE Dental Program when necessary to treat a severe congenital anomaly. Additionally, traditional braces and aligners are covered. To move teeth, treatment typically entails using dental appliances (such as braces, spacers, expanders, retainers, and headgear) in the mouth.
Students up to 21 or 23, depending on their academic standing, and couples up to 23 are eligible beneficiaries.
Does United Concordia cover invisible aligners?
United Concordia offers coverage for traditional braces and dental aligners up to the Lifetime Orthodontic Maximum (OLM) of $1,750 but does not specifically say whether they will cover at-home aligners. Treatment is administered based on dental health history, tooth molds, x-rays, and other factors.
How much do braces cost for adults?
Depending on the type of braces chosen, the average cost for adults ranges from $3,000 to $10,000. Ceramic braces range from $2,800 to $7,000, while traditional metal braces usually cost between $2,500 and $6,500.
. The cost of lingual braces typically ranges from $7,000 to $11,000. Adult braces could cost $2,000 per set in Houston.
Can I get braces at 35 years old?
Yes, adults over 35 can have braces. Even adults over the age of 50 can benefit from orthodontic treatment because there is no upper age limit for wearing braces.
Is Invisalign free for the military?
For military personnel, the Tricare Dental Program (TDP) will pay 50% of the cost of Invisalign up to a lifetime orthodontic limit of $1,750. Depending on the person’s particular circumstances, additional expenses might be covered.
Why can’t you join the army with braces?
Because metal wires and brackets present a danger of injury during combat and are thought to be a choking hazard, braces are a disqualification criterion for joining the military. The military will pay for the braces only if a doctor determines that braces are medically necessary. Before being formally sworn into the military, individuals wearing braces must have them completely removed.
Additionally, having bad dental health prevents you from joining the military.
However, depending on the severity of their teeth and the accessibility of orthodontists, some active-duty individuals have braces.
What does TRICARE not pay for?
Cosmetic dentistry, adult orthodontics, and dental implants are not covered by the TRICARE Dental Program (TDP). Additionally, unless a primary care dentist refers the patient, it does not cover services rendered by specialists. The TDP is only accessible to eligible family members of active duty, Selected Reserve, and IRR service members who are not on active duty.
Who is not eligible for Invisalign?
The Concordia orthodontic coverage for adults does not cover orthodontic care for active-duty personnel or retirees, including Invisalign.
Can you get free braces?
The TRICARE Dental Program covers braces for military dependents up to 21 (or 23 if they are enrolled full-time at an accredited university). Still, active-duty personnel must have a doctor deem the braces medically necessary to be covered.
Does TRICARE cover 100%?
Through the TRICARE Dental Program, TRICARE pays the full cost of all emergency, diagnostic, and preventive care; however, additional procedures may be subject to a cost-share, depending on the plan.
What are the three types of TRICARE?
The Federal Employees Dental and Vision Insurance Program (FEDVIP) and the TRICARE Dental Plan (TDP) are the two alternatives available for the TRICARE Dental Program. The TDP offers coverage for vision care in addition to emergency, diagnostic, and preventive care as well as restorative services, orthodontics, oral surgery, endodontics, and other non-medical services.
What age does TRICARE end?
The TRICARE Dental Program (TDP) covers unmarried biological, step-, and adoptive children until age 21 (or 23 if enrolled in college). Orthodontic services are subject to age restrictions, with eligibility expiring at 11:59 p.m. ET on the final day of the month they turn 21.
Is it worth getting Invisalign at 50?
Adults of any age, even those in their 40s, 50s, and beyond, can use Invisalign. It can be useful for addressing misalignment and other problems, like clenching your teeth, but weighing the pros and cons before deciding is important.
Is TRICARE for Life free?
Military retirees pay no enrollment fees or monthly premiums for TRICARE For Life. However, they must have Medicare Parts A and B, and the monthly premium for Medicare Part B is determined by income.
Does TRICARE for Life pay for dental?
TRICARE For Life does not cover dental services like diagnostic and preventive care, restorative care, orthodontics, oral surgery, endodontics, and other non-medical services. The Federal Employees Dental and Vision Insurance Program (FEDVIP) offers dental insurance to retirees and their dependents, while TRICARE covers adjunctive dental care when treating a medical illness.
On December 31, 2018, the TRICARE Retiree Dental Program (TRDP) ended.
What is the monthly cost for TRICARE for Life?
TRICARE For Life (TFL) does not require a monthly premium; however, Medicare Part B premiums must be paid monthly. Costs out of pocket vary for each service.
The monthly premiums for TRICARE Retired Reserve will increase slightly in 2022, and the annual enrollment fees for Group A, Group B, and Group A will be $171.96 and $547.92, respectively, in 2023.
How Much Does TRICARE dental cover per Year?
Orthodontics, oral surgery, endodontics, and other non-medical services are all covered by the TRICARE Dental Program. It also offers coverage for diagnostic and preventive services. Government-shared premiums and cost-shares provide the most coverage, but the quantity of coverage per year varies based on the type of treatment.
Uniformed retired service members can take advantage of the TRICARE Retiree Dental Program.
Conclusion
The Concordia orthodontic coverage for adults offers coverage for orthodontics for adults and their families. Exclusions and restrictions exist, but the plan covers various services and procedures. It is advised to review the plan’s specifics to prevent unforeseen expenses and to comprehend the coverage for orthodontic treatment.
Over 57,251 dentists and 237,000 access points are accessible through the nationwide Concordia Advantage network. Select the Dental tab or call the numbers provided to sign up for the dental plan. Referencing the member-specific benefit plan document is advised when determining coverage because it may vary from the typical dental plan.
To familiarize yourself with the advantages and coverage of Concordia orthodontic coverage for adults, it is crucial to read and review the certificate of coverage.
References
For Members of the U.S. Armed Forces – studentaid.gov. https://studentaid.gov/sites/default/files/military-student-loan-benefits.pdf
TRICARE Dental Programs. https://www.tricare-west.com/content/hnfs/home/tw/common/contact_us/dental.html
“United States : Udall, Heinrich Fight to Ensure Federal Employees Maintain Vision and Dental Insurance During Shutdown.” MENA Report, Albawaba (London) Ltd., Jan. 2019.
TRICARE Retiree Dental Program Guide – Webflow. https://uploads-ssl.webflow.com/5ab2de740c2abda025e29323/5cc0aa7eb1f03c7635ce7cd6_TDRP-TriCare.pdf
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