TRICARE Prime offers medical coverage to active duty and retired military personnel as well as to eligible dependent family members. Some of the medical services covered include routine vaccinations, blood tests, women’s health (including free contraception) check ups, managing existing conditions and diseases and much more. However, is dental care covered by TRICARE Prime?
What is Not Covered
Before you book your dental appointment, it is important to know what is not covered by TRICARE Prime. According to TRICARE, routine, preventative or restorative dental care is not covered by TRICARE Prime. Examples of dental treatment that is not covered by TRICARE Prime includes routine cleanings, check ups, treating gum disease, tooth extraction (including impacted wisdom teeth), implants, crowns, dentures and bridges, and the treatment of poor dental health that is a direct result of diseases such as rickets or congenital syphilis. If you need these kinds of treatments, you can receive them by registering with the TRICARE Dental Programme or TRICARE Retiree Dental Programme.
What is Covered: Adjunctive Dental Care
Although many routine treatments are not covered by TRICARE Prime, adjunctive dental care is covered. Adjunctive dental care is a service provided that is medically necessary for the treatment of a medical, rather than a dental, condition. It is also offered for treatment of an injury or disease. Prior authorisation is required in order for beneficiaries to take advantage of adjunctive dental care under TRICARE Prime.
Some of the adjunctive dental procedures that TRICARE Prime covers include the removal of teeth and tooth fractures in order to treat and repair facial trauma that has been caused by an injury, the treatment of complete ankyloglossia (tongue-tie) in order to overcome the problem of swallowing or difficulty speaking. Dental or orthodontic care that is related to the medical and/ or surgical correction of a severe birth defect are procedures that are also covered. Dental care is also provided for TRICARE Prime beneficiaries who are in line for radiation therapy as a result of oral or facial cancer.
Although TRICARE Prime does not offer routine, restorative or preventative dental care, coverage is offered for adjunctive care. Check with TRICARE to see if you are covered and if you need prior authorisation to receive treatment.