TRICARE Dental Program covers braces, but does it cover clear aligners?

  • Published
  • TRICARE Communications

Are you wondering if you can get clear aligners with the TRICARE Dental Program, or TDP?

That’s a common question many TDP enrollees have — and we’ve got the answer for you. The TDP covers 50% of the cost of clear aligners and other orthodontic services up to the lifetime orthodontic maximum of $1,750. Your dentist must administer the clear aligners for them to be covered by the TDP.
What exactly are clear aligners?
According to the American Association of Orthodontics, clear aligners are an alternative to traditional braces. Think of them as invisible braces. They’re clear, thin, plastic-like trays that orthodontists use to correct teeth that are crooked or crowded. You can put them in your mouth and remove them as needed, like when you’re eating a meal or brushing or flossing your teeth.
Am I eligible for clear aligners?
Your dentist may recommend orthodontic care, like clear aligners, if he or she believes you need treatment. The TDP covers clear aligners the same way it covers regular braces. Eligible enrollees include:

  • National Guard and Reserve sponsors under age 23
  • Spouses of active duty or National Guard and Reserve sponsors under age 23
  • Children under age 21, or under age 23 if enrolled full time at an accredited college or university

How do I get clear aligners?
When you’re ready, make an appointment with an orthodontist. You can find one near you using the Find a Dentist Tool on the TDP website. Once you’ve met with the orthodontist, you’ll need to request a predetermination from United Concordia.
“A predetermination lets you and your orthodontist know how much United Concordia will cover and how much you’ll pay for the clear aligners,” said Doug Elsesser, program analyst with the Defense Health Agency’s TRICARE Dental Program. “Once your orthodontist submits a treatment plan, United Concordia will send you and your orthodontist a notice of the treatment plan payment schedule.”
Enrollees who live in the OCONUS service area must have an approved TDP OCONUS Non-Availability and Referral Form, or NARF, before seeing an orthodontist. You can learn more about how to get care in the “Orthodontic Services” section of the TRICARE Dental Program Handbook.
Looking to catch up on the latest dental news? Make sure you check out issue 3 of the TRICARE Dental Program Health Matters Newsletter. You’ll find details about covered services, costs, filing claims, and tips to help improve your dental health.