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Old 02-10-2011, 11:03 AM   #1
tishmomof2
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Default United concordia and braces?

Do they help with that at all? like a percentage or something for childrens,, I cant seem to find that info online.TIA
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Old 02-10-2011, 11:05 AM   #2
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Default Re: United concordia and braces?

They did for us. At the time we used it dh was deployed (he's national guard so we normally don't pay for United Concordia) and they would pay up to $1500 lifetime benefit for Orthodontia. Better than most insurance.
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Old 02-10-2011, 11:51 AM   #3
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Default Re: United concordia and braces?

If you log in to your UC account and click on your child's name then on Benefit Information, you can find it. http://www.tricaredentalprogram.com/tdptws/home.jsp

For my son, it's the sixth item down: "Age limitations, lifetime maximum, braces, retainers and other orthodontic procedures".

ORTHODONTIC SERVICES
ORTHODONTIC SERVICES COULD CONSIST OF THE FOLLOWING:
TREATMENT PLANS FOR THE CORRECTION OF AN EXISTING
HANDICAPPING MALOCCLUSION AND ITS ATTENDANT SEQUELAE THROUGH
THE CORRECTION OF MALPOSED TEETH CONSISTING OF: DIAGNOSIS
(INCLUDING RADIOGRAPHS), ACTIVE TREATMENT (INCLUDING
NECESSARY APPLIANCES), AND RETENTION TREATMENT FOLLOWING
ACTIVE TREATMENT. (PLEASE REFER TO THE DETAIL BELOW.)
DEPENDENT CHILDREN ARE COVERED UNDER AGE 21.
.
STUDENTS ARE COVERED UNDER AGE 23.
.
SPOUSES ARE COVERED UNDER AGE 23.
.
SELECTED RESERVE AND IRR SERVICE MEMBERS ARE COVERED UNDER
AGE 23.
THE FOLLOWING ORTHODONTIC SERVICES ARE INELIGIBLE:
.
- PRETREATMENT ORTHODONTIC VISIT (D8660)
- REPAIR OF ORTHODONTIC APPLIANCE (D8691)
- REPLACEMENT OF LOST OR BROKEN RETAINER (D8692)
- REBONDING OR RECEMENTING; AND/OR REPAIR, AS REQUIRED,
OF FIXED RETAINERS (D8693)
ONE CEPHALOMETRIC X-RAY (D0340) IS ELIGIBLE DURING
A TWELVE MONTH PERIOD.
PAYMENT IS MADE AT 100% OF THE ALLOWANCE FOR CEPHALOMETRIC
XRAYS (D0340).
.
PAYMENT IS MADE AT 50% OF THE ALLOWANCE FOR ALL REMAINING
ELIGIBLE ORTHODONTIC SERVICES.
LIFETIME SERVICE DOLLAR MAXIMUM IS $1500.00 PER
PERSON AND APPLIES TO ALL ORTHODONTIC SERVICES, EXCLUDING
THE FOLLOWING ORTHODONTIC DIAGNOSTIC SERVICES:

.
- LATERAL SKULL AND FACIAL BONE FILMS (D0290)
- CEPHALOMETRIC FILMS (D0340)
- STUDY MODELS (D0470)
.
THE ABOVE ORTHODONTIC DIAGNOSTIC SERVICES ARE APPLIED TO
THE $1200.00 PROGRAM DOLLAR MAXIMUM.
THE INITIAL PAYMENT WILL BE THE EQUIVALENT OF 25% OF
OUR LIABILITY. THE REMAINING BALANCE WILL BE PAID IN
QUARTERLY INCREMENTS, THROUGHOUT THE COURSE OF ACTIVE
ORTHODONTIC TREATMENT.
PAYMENT INFORMATION
PRICING = TDP SCHEDULE OF ALLOWANCES
THERE IS NO PROGRAM DOLLAR DEDUCTIBLE (PDD).
PROGRAM DOLLAR MAXIMUM IS $1200.00 PER PERSON
PER CONTRACT YEAR (FEB 1 - JAN 31).
.
MAXIMUM APPLIES TO ALL ELIGIBLE SERVICES EXCEPT FOR THE
FOLLOWING:
.
- EVALUATIONS (D0120, D0145, D0150)
- FULL MOUTH X-RAYS (D0210, D0330)
- PERIAPICAL X-RAYS (D0220, D0230, D0240)
- BITEWING X-RAYS (D0270, D0272, D0273, D0274, D0277)
- CARIES SUSCEPTIBILITY TESTS (D0425)
- CLEANINGS (D1110, D1120)
- FLUORIDE TREATMENTS (D1203, D1204, D1206)
.
** ORTHODONTIC SERVICES ARE EXCLUDED FROM THE PROGRAM
DOLLAR MAXIMUM EXCEPT FOR THE FOLLOWING ORTHODONTIC
DIAGNOSTIC SERVICES:
.
- LATERAL SKULL AND FACIAL BONE FILMS (D0290)
- CEPHALOMETRIC FILMS (D0340)
- STUDY MODELS (D0470)

PROVIDERS IN THE NATIONAL FEE FOR SERVICE NETWORK ARE
CONSIDERED PARTICIPATING.
MAILING ADDRESS FOR TDP CLAIMS:
.
UNITED CONCORDIA COMPANIES, INC.
TDP CLAIMS PROCESSING
P.O.BOX 69411
HARRISBURG, PA 17106-9411

PARTICIPATING PROVIDERS WILL RECEIVE PAYMENTS AND
NON-PAYMENT EXPLANATION OF BENEFITS (EOBS).
.
ASSIGNMENT OF BENEFITS - NON-PARTICIPATING PROVIDERS WILL
RECEIVE PAYMENTS IF BENEFITS ARE ASSIGNED TO THE PROVIDER,
BY THE MEMBER. NON-PARTICIPATING PROVIDERS WILL RECEIVE
EOBS.
.
MEMBERS WILL RECEIVE PAYMENTS FOR SERVICES WHICH HAVE
BEEN PAID IN ADVANCE OR FOR SERVICES PERFORMED BY NON-
PARTICIPATING PROVIDERS WHEN BENEFITS ARE NOT ASSIGNED TO
THE PROVIDER. MEMBERS WILL RECEIVE EOBS FOR ALL CLAIMS
VIA U.S. MAIL OR ONLINE.
EXPLANATION OF BENEFITS
THIS PROVISION CONTAINS CLAIM PAYEE AND EXPLANATION
OF BENEFITS (EOB) RECIPIENT INFORMATION.
PARTICIPATING PROVIDERS WILL RECEIVE PAYMENTS AND
NON-PAYMENT EXPLANATION OF BENEFITS (EOBS).
.
ASSIGNMENT OF BENEFITS - NON-PARTICIPATING PROVIDERS WILL
RECEIVE PAYMENTS IF BENEFITS ARE ASSIGNED TO THE PROVIDER,
BY THE MEMBER. NON-PARTICIPATING PROVIDERS WILL RECEIVE
EOBS.
.
MEMBERS WILL RECEIVE PAYMENTS FOR SERVICES WHICH HAVE
BEEN PAID IN ADVANCE OR FOR SERVICES PERFORMED BY NON-
PARTICIPATING PROVIDERS WHEN BENEFITS ARE NOT ASSIGNED TO
THE PROVIDER. MEMBERS WILL RECEIVE EOBS FOR ALL CLAIMS
VIA U.S. MAIL OR ONLINE.
PROVIDER NETWORK INFORMATION
PROVIDERS IN THE NATIONAL FEE FOR SERVICE NETWORK ARE
CONSIDERED PARTICIPATING.
MAILING ADDRESS FOR TDP CLAIMS:
.
UNITED CONCORDIA COMPANIES, INC.
TDP CLAIMS PROCESSING
P.O.BOX 69411
HARRISBURG, PA 17106-9411
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Old 02-10-2011, 11:52 AM   #4
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Default Re: United concordia and braces?

Yeah, all of that my son has braces right now and they are covering 1500.
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Old 02-10-2011, 01:10 PM   #5
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Default Re: United concordia and braces?

I'm mad that they won't cover me since I'm over 23 and need braces...
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Old 02-10-2011, 01:11 PM   #6
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Default Re: United concordia and braces?

Quote:
Originally Posted by SarahMay View Post
I'm mad that they won't cover me since I'm over 23 and need braces...
They didn't cover me either, so I ended up checking with my insurance I had at the time and they covered 50% of my braces. It was actually more through my insurance, so that part was good at least.
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Old 02-10-2011, 01:58 PM   #7
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Default Re: United concordia and braces?

ive had some troops who were denied coverage for braces for their kiddos cause their kids weren't considered to be bad enough, i am pretty sure.
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Old 02-10-2011, 02:14 PM   #8
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Default Re: United concordia and braces?

Quote:
Originally Posted by marybeth View Post
ive had some troops who were denied coverage for braces for their kiddos cause their kids weren't considered to be bad enough, i am pretty sure.
Wow that is insane. It wasn't even a question of how bad my sons teeth were. We just got them put on and they have been paying. And for what its worth, my sons teeth weren't that bad at all, but figured we should do it now at 11/12 then wait too long.
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Old 02-10-2011, 03:22 PM   #9
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Default Re: United concordia and braces?

so it's $1500 per person? I thought it was $1500 total across the family...not per person.
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Old 02-10-2011, 03:50 PM   #10
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Default Re: United concordia and braces?

Quote:
Originally Posted by marybeth View Post
ive had some troops who were denied coverage for braces for their kiddos cause their kids weren't considered to be bad enough, i am pretty sure.
Interesting, they covered DS and his weren't bad at all...never heard of such a thing
Quote:
Originally Posted by Mrs.C View Post
so it's $1500 per person? I thought it was $1500 total across the family...not per person.
They pay 1/2, up to $1500 per person per lifetime....

Also, some of the things that may need to be done before braces can get done on base to help the cost. DS had to have teeth pulled and a TAD put in, which we were able to have done at Portsmouth eliminating that cost from our overall out of pocket expense.
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