Written by: Bridget Daniels Carlson
On May 1, 2012 you can say goodbye to United Concordia and hello to MetLife for your dental insurance. Recently MetLife was awarded the TDP contract which will go into effect on May 1st. With the change comes new TDP benefits and changes which include the following:
- Decrease in monthly premiums beginning May 1, 2012 (see chart towards end)
- Coverage of resin fillings on all teeth
- Increase in the annual maximum from $1,200 to $1,300 per enrollee
- Increase in the orthodontic lifetime maximum $1,500 to $1,750 per enrollee
- An added $1,200 annual accident maximum (for dental care provided due to an accident)
- No cost shares for scaling and root planing for diabetics
- New plan year beginning May 1st and ending April 30 (old plan year was February 1 – January 31)
- Coverage of an additional (3rd) cleaning for women during pregnancy
- Expansion of the survivor benefits to surviving spouse and child(ren)
So what does this really mean for you? The percentage of the cost share for services has not changed. If your husband is an E5 or higher and you need oral surgery, your cost share is still 40%. But as stated above, MetLife will now include coverage of some services (such as resin fillings) that were not previously covered under United Concordia.
The claim process is still the same. If you use an in network provider, that provider will submit the claim on your behalf and MetLife will pay the provider directly. If you use an out of network provider, you may be responsible for filing the claim yourself (as has always been in the past). Whether an out of network provider will file on your behalf varies from provider to provider.
However, in order to avoid a potential break in coverage for those who have their premiums automatically deducted from a bank account or credit card, should contact MetLife to reauthorize their recurring premium payments between March 21 and April 20, 2012. They can contact MetLife by calling 1-855-638-8371. Those who pay premiums via an allotment from a military payroll account do not need to take any action.
If you haven’t received your new benefits booklet in the mail yet, you soon will. You will see (if you compare the new one to the old one) there really is not that much difference other than new coverage has been added and maximum benefits raised. However, if you have any questions, please leave your comments below and I will answer them after getting the information for you. It’s also important to note that this change does not affect the TRICARE Retiree Dental Program which is administered by Delta Dental of California or The Active Duty Dental Program which will still be administered by United Concordia.
If you can’t wait to look at the benefits and changes:
- Active Duty – $0 (old $0)
- Selected Reserve — $10.30 (old $12.69)
- Individual Ready Reserve – $25.74 (old $31.72)
Single Premium (one family member) :
- Active Duty — $10.30 (old -$12.69)
- Selected Reserve – $25.74 (old – $31.72)
- Individual Ready Reserve – $25.74 (old – $31.72)
Family Member (more than one person, excluding sponsor)
- Active Duty — $30.89 (old -$31.72)
- Selected Reserve $77.22 (old – $79.29)
- Individual Ready Reserve – $77.22 (old $79.29)