TRICARE dental program

Question 0

What are the two TDP geographical service areas?

Answer 0

CONUS and OCONUS

Question 1

The TRICARE dental program is administered by who?

Answer 1

MetLife

Question 2

What areas are include in the TDP CONUS area?

Answer 2

All 50 states
DC
Puerto Rico
Guam
U.S. virgin island

Question 3

What does DEERS stand for?

Answer 3

Defense enrollment eligibility reporting systems

Question 4

Unmarried children of active duty service members are eligible for the TDP until what age?

Answer 4

21

Question 5

Unmarried children of active duty service members are eligible for the TDP between the ages of 21-23 if one of what two things occur?

Answer 5

Full time student and Sponser provides over 50% of the financial support

They have a disability illness or injury before they turned 21 or while the were a full time student between 21-23

Question 6

Who can add or delete family members within DEERS?

Answer 6

Only the Sponser

Question 7

The addition or deletion of family members require one of what four papers?

Answer 7

Marriage license
Divorce decree
Birth certificates
Death certificates

Question 8

What are four ways a Sponser can update DEERS?

Answer 8

Website
In person at a local office
Call defense manpower
Fax

Question 9

Are ADSM eligible for TDP?

Answer 9

No

Question 10

Are retired service members and their families eligible for TDP?

Answer 10

No

Question 11

Are former spouses eligible for TDP?

Answer 11

No

Question 12

Are disabled vets eligible for TDP?

Answer 12

No

Question 13

What are the two TDP plans?

Answer 13

Single

Family

Question 14

Children under what age maybe volunteered to enroll in TDP but is not automatic?

Answer 14

4

Question 15

If there is an existing family plan in effect, children will be automatically enrolled when?

Answer 15

First day of the month that they turn 4

Question 16

What is the required method of payment for ongoing TDP coverage?

Answer 16

Payroll allotment

Question 17

If initial payment to metLife is submitted prior to what day, coverage will start the first day of the next month?

Answer 17

20th

Question 18

Sponsors who fail to pay premiums will be locked out for how long?

Answer 18

12 months

Question 19

If the Sponsor dies, the surviving spouse and children are eligible for TDP survivor benefits for how long?

Answer 19

3 years

Children same age rules apply

Question 20

If the spouse is not enrolled in the TDP at time of sponsors death are they eligible for TDP survivor benefits?

Answer 20

Yes they can enroll at any time

Question 21

The government will pay what percent of the premiums of the TDP survivors benefits?

Answer 21

100%

Question 22

What program are spouses of deceased Sponser eligible for after the three years of TDP survivors benefits?

Answer 22

TRICARE retiree dental program

Question 23

What is the form DD form 2813?

Answer 23

DOD active duty/reserve forces dental exam form

Question 24

Do reservist and national guard need to pay for their annual screening?

Answer 24

No

Question 25

MetLife recommends that your dentist submit a predetermination request when the cost is expected to be above what price?

Answer 25

$300

Question 26

What happens if you use a no -network dentist?

Answer 26

You have to pay the difference from what MetLife wont pay | Also they might not submit your claim on your behalf

Question 27

What is the premium share for family members of ADSM?

Answer 27

60% government | 40% beneficiary

Question 28

If the Sponser has a military payroll account, and if sufficient funds are available the government will collect the sponsor's share of the premium through what?

Answer 28

Uniformed service finance center

Question 29

What is the annual maximum benefit per beneficiary, per plan year for non-orthodontic services?

Answer 29

$1,300

Question 30

What are the dates for the plan years?

Answer 30

1 may till 30 April

Question 31

What is the lifetime max benefits for orthodontic treatment per beneficiary?

Answer 31

$1,750

Question 32

In addition to the annual maximum, there is an accidental annual max. What is it?

Answer 32

$1,200

Question 33

How many routine prophylaxis visits are covered in a consecutive 12 month period?

Answer 33

2 | Unless pregnancy then you must document it and you get a third visit

Question 34

Adult prophylaxis will be allowed on patients what age or older?

Answer 34

13

Question 35

How many topical fluoride applications are allowed in a 12 months period?

Answer 35

2

Question 36

Sealants are only covered on what teeth?

Answer 36

Permanent molars

Question 37

Who is eligible for orthodontic treatment?

Answer 37

Family members non-spouse with same age requirements as everything else Spouses till age 23

Question 38

Claims submitted how many months after service will be denied?

Answer 38

12

Question 39

If a beneficiary receives treatment from. MetLife approved dentist who will MetLife pay?

Answer 39

The dentist. The dentist will then bill the pt for the difference

Question 40

If a beneficiary receives treatment from a non-MetLife dentist who will MetLife pay?

Answer 40

The beneficiary

Question 41

What are the three levels of appeal?

Answer 41

Reconsideration Formal review Hearing