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Effective May 1, MetLife will begin providing dental coverage to more than two million family members of uniformed service active duty personnel, members of the Selected Reserve and Individual Ready Reserve, their eligible family members and survivors.
Note that the change to MetLife is for the TDP program only. United Concordia Companies, Inc. will continue to administer the Active Duty Dental Program and the Delta Dental Plan of California will continue to administer the program for retired service members and their families.
Changes under MetLife including benefits and enhancements to the TDP include:
• Lowered premiums, one family member — $10.30/per month; families — $30.89/per month.
• Yearly (annual) maximum benefit raised from $1,200 to $1,300.
• Lifetime orthodontic maximum benefit raised from $1,500 to $1,750.
• Additional $1,200 annual maximum benefit for services related to dental accident treatment.
• Three cleanings per year for pregnant or diabetic patients.
• Coverage of posterior resin (white) fillings.
• No cost shares for scaling and planing (deep cleaning) for diabetic patients when visiting an in-network dentist.
• Non-Availability Referral Forms will not be required for implants, only orthodontic treatment.
• Listings of TRICARE OCONUS Preferred Dentists maintained at MetLife web site (www.metdental.com).
To obtain service assistance, transition information, or to locate a dentist, visit MetLife at https://mybenefits.metlife.com/tricare or www.facebook.com/MetLifeTDP. In addition, the MetLife customer service call centers are available to assist TDP members with questions, concerns or issues related to billing, enrollment/disenrollment, claims and general inquiries related to TDP program.
MetLife OCONUS Customer Service is accessed by calling the AT&T Operator in your country and then dialing 1-855-638-8372. Claims can be sent in by regular mail (PO Box 14182, Lexington, KY 40512), fax to 001-855-763-1334, or you can scan/email to OCONUSDentalClaims@metlife.com.
Questions or issues regarding claims for dates of service prior to May 1, should still be directed to the current insurance carrier. Orthodontic treatment will still require a Non-Availability and Referral Form that will be issued to the doctor and/or the patient following a review of the orthodontic treatment plan by the TRICARE Area Office Dental Consultant. After the case is reviewed and the NARF is sent to the family/dentist, orthodontic treatment may begin (and the braces will be placed). As soon as the braces are placed, the orthodontic claim should be filed by sending MetLife the following:
• The completed NARF
• The completed Claim Form (orthodontic banding date should be included on the claim form)
• The provider’s bill for the total cost of care, and for the orthodontic exam.
Within 3 to 4 weeks, MetLife will send a check for the appropriate amount to the orthodontist. The sponsor and the dentist should establish a workable payment program.
