Monthly Premiums

Your monthly premium rate depends on where you live and the number of family members you choose to enroll.

You're required to pay your monthly premium payments through a military retired pay allotment. If you aren't collecting retirement pay, or if the amount of your retirement not enough for an allotment, complete the Authorization for Electronic Funds Transfer (EFT) form to have your premiums deducted from your bank account. If you don't set up an EFT payment before your first monthly premium is due, you may lose coverage.

Cost Shares

Below is an overview of benefits and cost shares provided under the TRICARE Retiree Dental Program. For additional information, view the Benefits Booklet.

Benefits During the First 12 Months of Enrollment

Benefit  Delta Dental Pays
Diagnostic Services (i.e. exams) 100%
Preventive Services (i.e. cleanings) 100%
Basic Restorative Services (i.e. fillings) 80%
Endodontics (i.e. root canals) 60%
Periodontics (i.e. gum treatments) 60%
Oral Surgery (i.e. extractions) 60%
Emergency Services         80%
Dental Accident Coverage 100%

Additional Benefits Available After 12 Months

The following additional benefits are available after 12 months of continous enrollment or if you enroll within four months of retirement.

Benefit  Delta Dental Pays
Cast Crowns, Onlays & Bridges          50%
Partial/Full Dentures 50%
Orthodontics 50%
Dental Implants 50% 

Deductibles & Maximums

  • Annual deductible (per person, $150 cap per family, per benefit year): $50
  • Annual maximum (per enrollee, per benefit year):  $1300
  • Orthodontic maximum (per person, per lifetime):  $1750
  • Dental Accident Maximum (per person, per benefit year): $1200

Last Updated 2/4/2014

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Delta Dental

Stateside: 1-888-838-8737
Overseas: (AT&T USADirect Access Number) + 866-721-8737

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