Cost-Shares

You’ll pay cost-shares for covered dental services, in addition to paying monthly premiums. Your cost-shares depend on:

• The type of service you get
• Your sponsor’s pay grade
• Where you live (the CONUS service area or the OCONUS service area)

Covered Services	CONUS Service Area Pay Grades E-1 Through E-4	CONUS Service Area Pay Grades E-5 and Above	OCONUS Service Area Command-Sponsored Beneficiaries1
	Diagnostic	0%	0%	0%
Preventive2	0%	0%	0%
Sealants	0%	0%	0%
Consultation/Office Visit	20%	20%	0%
Post-Surgical Services	20%	20%	0%
Basic Restorative	20%	20%	0%
Endodontic	30%	40%	0%
Periodontic	30%	40%	0%
Oral Surgery	30%	40%	0%
General Anesthesia	40%	40%	0%
Intravenous Sedation	50%	50%	0%
Miscellaneous Services (occlusal guard, athletic mouth guard)	50%	50%	0%
Other Restorative	50%	50%	50%
Implant Services	50%	50%	50%
Prosthodontic	50%	50%	50%
Orthodontic3	50%	50%	50%

¹ Doesn’t apply to Selected Reserve and Individual Ready Reserve members (other than Special Mobilization Category) and their families. They’ll pay CONUS cost-shares.

² The TDP fully covers space maintainers for posterior teeth for enrollees under age 19. They’re covered at a 20% cost-share for enrollees under age 19 when replacing anterior teeth only.

³ Available for enrolled family members. The TDP covers:

• Children up to age 21 or 23, based on their student status
• Spouses up to age 23
• National Guard and Reserve sponsors up to age 23

Your dental coverage has specific limits and exclusions. See the TRICARE Dental Program Handbook for more information.