Coming this November the TRICARE Retiree policy will no longer exist. Current and future Subscribers will be given options for new dental plans. In this blog I will outline which plans may be the best option for you. The new dental plans are called FEDVIP plans. These are dental and vision plans that are offered to federal employees. In the past retired military members and their families were covered under a separate TRICARE policy administered by Delta Dental of California. This is the plan that will no longer exist at the end of this year. All retirees are being grouped in with all federal employees (does not affect active duty, reserve, guard or dependent coverage for active and guard).
So what are your new options? Aetna, BCBS FEP, GEHA, Delta Federal, MetLife and United Concordia. My recommendation of what plans to pick is based on my experiences with these plans and our participation status as well as the participation status of the other specialty offices we work closely with. I will give my opinion with each of these plans below. Note my opinion is not based on our reimbursement but what is best for you. The plans I do not recommend actually pay us more.
Aetna: Small network of participating doctors. Higher out of pocket costs and less options for care in the area. NOT Recommended.
GEHA: Little to no in network participation with providers. Lower premium. Substantially higher out of pocket. No participating specialists. NOT Recommended.
BCBS FEP: Basically a medical plan with limited dental coverage. Higher out of pocket. Larger participating provider base. I only recommend these FEP plans for individuals who have had no dental issues and only receive 1 to 2 routine cleanings per year. LIMITED Recommendation.
Delta Federal: This plan is most like the current TRICARE plan that you are use to. This plan has the highest premiums, but will have the lowest out of pocket for services that are not covered at 100%, like fillings, crowns, extractions and root canals. Preventative services (routine cleanings) are usually covered at 100%. This plan has the largest pool of participating providers, general and specialty. HIGHLY Recommend.
Met Life: This plan will have a lower premium than Delta with similar coverage levels, minus fluoride. Routine cleanings and x-rays are usually covered at 100%. Restorative work is covered between 50 and 80 percent, same as Delta. The provider base is smaller. We are a participating provider but most specialists in the area are not. Be prepared to travel to the east side of the state for an oral surgeon or endodontist (root canal). RECOMMEND if you want a good dental plan at a descent premium and do not have extensive dental issues.
United Concordia: This plan will have a lower premium than Delta, and about on par with the Met Life policy. Routine cleanings and x-rays are usually covered at 100%. Restorative work is covered between 50 and 80 percent, same as Delta. The provider base is smaller than even Met Life. We are a participating provider but most specialists in the area are not. Be prepared to travel to the east side of the state for an oral surgeon or endodontist (root canal). RECOMMEND if you want a good dental plan at a descent premium and do not have extensive dental issues.
In conclusion here is my recommendation order from Most Recommended to Least.
Delta Federal (MOST)
Met Life FEDVIP
United Concordia FEDVIP
Estimated prices for each plan is attached below. This is for the 49014 zip code. You can compare plans on Benefeds.com
If you have any questions or concerns please feel free to contact me (269-964-755). I am happy to work any of our veterans and their families through this transition.
Views and opinions of Tyler Kerr, not the official views of Charles H. Palumbo DDS, PC.