The TRICARE Dental Program limits how much can be paid per enrollee for dental services. Only the allowed fee (or the dentist's actual charge if lower) less your cost share is applied against the maximum. Please view the TRICARE Dental Program Benefit Booklet for a complete list of services that do not apply to your plan maximums.
Annual Maximum for Non-Orthodontic Services
- $1,300 per enrollee, per contract year (May 1-April 30)
- Payments for certain diagnostic and preventive services are not applied against the annual maximum
- In the OCONUS service area, the government pays for any valid costs in excess of the allowed amount up to the billed charge for all enrollees except Selected Reserve and IRR family members, IRR (other than special mobilization category) members, and/or those who are not command-sponsored.
Lifetime Maximum for Orthodontic Treatment
- $1,750 per enrollee
- Orthodontic diagnostic services are applied to the annual maximum
Accidental Annual Maximum
For costs associated with dental care provided due to an accident (injury to the teeth and/or supporting hard and soft tissues from external blunt forces and not due to chewing or biting)
- $1,200 per enrollee
- After accidental maximum is met, additional costs are applied to the $1,300 annual maximum