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Using the TRICARE Dental Program Overseas
Updated March 8, 2005
The TRICARE Dental Program (TDP), administered by United Concordia Companies Inc. (UCCI), is offered outside of the continental United States (OCONUS) service area. The OCONUS service area includes all other countries, island masses and territorial waters not in the continental United States (CONUS) service area (the 50 United States, District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands). Additionally, any services provided on a ship or vessel that is outside of the territorial waters of the CONUS service areas are covered under the OCONUS service area. The OCONUS service area is categorized into non-remote and remote locations.
Non-Remote vs. Remote Countries:
Non-remote locations are those OCONUS countries that have a fixed uniformed services overseas dental treatment facility (ODTF). If ODTFs are unable to provide the TDP covered services, they may authorize enrolled members to receive the covered services from host country dentists. Non-remote countries include: Azores, Bahrain, Belgium, Diego Garcia, Germany, Iceland, Italy/Sardinia, Japan, Portugal, South Korea, Spain, Turkey and the United Kingdom.
Remote locations are those OCONUS countries that do not have a fixed uniformed services ODTF, including those that may have a part-time fixed ODTF. All countries not included in the non-remote OCONUS list (above) are considered remote.
In non-remote countries, most care will be received at the ODTF. Family members of active duty service members in non-remote countries must receive a non-availability and referral form (NARF) and use dentists on the OCONUS provider listing for both routine dental care and orthodontic care outside the ODTF. TDP enrollees in remote OCONUS countries must receive a NARF and use the OCONUS provider listing for orthodontic care only, but may use any dentist for non-orthodontic (routine) dental services; however, seeking dental care from the OCONUS provider listing is encouraged.
Eligibility:
The TDP is available for eligible Family members of active duty uniformed services members, eligible Family members of Selected Reserve and Individual Ready Reserve (IRR), as well as Selected Reserve and IRR members not on active duty.* All enrollees are eligible for dental care in either the CONUS or OCONUS service areas. Family members do not have to be command-sponsored, listed on the sponsor’s change of assignment orders or formally recognized as a Family member on an accompanied tour to receive dental care in the OCONUS service area.
TRICARE Dental Program Benefits Overseas:
TDP benefits, limitations and exclusions are the same for both CONUS and OCONUS service areas. Some covered services may be unavailable in certain OCONUS locations. Additionally, sponsors and Family members may have to pay for covered services before they are rendered and file a claim with UCCI for payment reimbursement.
OCONUS Dentists:
UCCI is not required to establish a dental network in the OCONUS service area. The requirements for a dentist to be within 35 miles of a member's home and the 21-day limit (access standard) for obtaining an appointment do not apply to members in the OCONUS service area. The ODTFs and the TRICARE Area Offices (TAOs) identify host nation dentists and place them on the OCONUS provider listing, which is available from the ODTFs. This information may also be available from the U.S. Embassy or Consulate Office.
For more information about receiving orthodontic care in OCONUS areas including cost-shares, payment procedures and transferring orthodontist care from CONUS to OCONUS areas, please visit the TRICARE Dental Program Web site at http://www.ucci.com/tdp/tdp.html and download the benefit booklet.
OCONUS Dental Claims:
The TDP OCONUS claim form (Attending Dentist’s Statement) is available from TAOs, ODTFs, designated OCONUS Points of Contact (POCs), or it can be downloaded from http://www.ucci.com. Specific claims submission, processing and payment procedures apply to OCONUS claims. All claims must be completed and submitted to UCCI, preferably within 60 days. Any claims submitted after 12 months from the date the service was completed will be denied for lack of timeliness. To file a claim, submit via mail a completed claim form, the dentist bill or statement of charges and the NARF to: United Concordia, TDP OCONUS Dental Unit, P.O. Box 69418, Harrisburg, PA 17106-9418.
OCONUS Point of Contact (POC) Program:
The OCONUS POC is a designated active duty service member or civilian employee who can assist sponsors and Family members with dental claims overseas. To find out if there is an OCONUS POC near you, contact the TAO or ODTF in your area. A toll-free fax number is available 24 hours per day, seven days per week at 1-888-475-0486.
For more information, call your country’s AT&T access number and then dial toll-free 1-888-418-0466 from Australia, Bahrain, Belgium, Bolivia, Columbia, Egypt, Germany, Greece, Iceland, Italy, Japan, the Netherlands, Norway, Panama, Portugal, Saudi Arabia, South Korea, Spain, Switzerland, Turkey and the United Kingdom. Call 1-717-975-5017 (not toll-free) from all other OCONUS locations. Representatives are available to assist 24 hours per day in English, German and Italian. You can also send e-mail requests to oconus@ucci.com
