TRICARE Dental: Frustrations Continue With New Network Changes

TRICARE Dental Changes

We asked you to tell us your thoughts about the new United Concordia TRICARE Dental Program (TDP) contract. And we heard you loud and clear: you’re not happy.

With TRICARE, contract changes are a fact of life and there is always some level of discontent with those changes. We have been vigorously working on this issue for your military family.

So what’s the real problem here?

There are two parties responsible for the quality of the TRICARE Dental Program benefit. The Defense Health Agency (DHA) is responsible for procurement and oversight of the TDP contract, while United Concordia (the contractor) is responsible for administering the dental benefit. We have met with both DHA and United Concordia and told them about your frustrations with the new TDP network. Some of those concerns are:

  • Reduced choice of dental providers for military families who are trying to minimize their out-of-pocket expenses by using network providers

  • Concerns about the quality of dental care provided by dentists who are willing to accept the lower reimbursement rates

  • Disrupted care by requiring provider changes for a population that already sacrifices continuity of care with each PCS move

It is important to note that we are not saying these complaints are universal—certain areas are experiencing more network churn than others. However, the range and intensity of the outcry we’ve heard from you seems more pronounced than we have experienced with past contract transitions.

There is clearly a least in certain areas.

But DHA and United Concordia are both holding firm that there is no problem with the TRICARE Dental Program networks. DHA says the terms of the contract have not changed, and United Concordia contends that they are meeting the contractual access standards (a general dentist within 35 miles and an appointment available within 21 days). United Concordia emphasizes that network issues are isolated and they are currently working to resolve problem areas such as Tidewater, Fort Leavenworth, and Fort Campbell.

We know most military families haven’t had issues finding a dentist within the 35 mile range, who can see them within 21 days. But it seems that the value of the TRICARE Dental Program benefit has been diminished for a pretty significant segment of military families. Specifically for families who have to switch dentists, families who have to travel further for dental care, and families who are no longer confident in the quality of care provided by network dentists who are willing to accept reduced reimbursements.

We have exhausted our options with DHA and United Concordia. They believe the stories and experiences we are hearing from military families, like yours, and from dentists are simply part of the typical contract transition. Unfortunately, it is impossible for our organization to singlehandedly quantify how many families are negatively affected by the new network. 

That’s why we need your help.

If you are unhappy with the new TRICARE Dental Program network, please contact your Members of Congress and let them know why. It’s not tough, we promise! We’ve provided a couple tools to help you below. You might be skeptical that your message will make a difference, but all offices have staff to monitor emails. Be assured your message will be read. Your voices will help us make the case that military families deserve a high quality dental benefit!

Find and contact your Representative

Find and contact your Senator

Posted May 25, 2017


From: Kimberly on: January 18, 2018
I have had nothing but stress trying to get United Concordia Tricare to pay their portion of my dentist bills. I have yet to have a single claim filed that they have paid without me having to call repeatedly over months. I still have claims from May 30th 2017 that have not been paid. I have had to file an appeal and still nothing. I have five other orthodontic claims that they paid nothing out on, as they stated I did not have coverage. After numerous calls they have determined that I did in fact have coverage, but was told that orthodontics was a different department. When I asked for the number I was informed that they do not have one. My current dentist is now refusing to submit claims directly from there office due to all the hassle. This will force me to have to file all the dental claims on my own or just to pay the bills in full out of pocket.
From: Melissa on: December 3, 2017
Actually, the terms for finding a provider is that Tricare must provide access to an in Network provider with a 15 mile radius (not 35 as stated in article) from the patients Home and within 21 days of their phone call to Tricare. If they cannot provide an appointment for a non-emergency appointment in this time frame they must provide you a Authorization Number. The Authorization number will allow the patient to see a dentist of their choice. In this instance, the patient will not pay anymore than if they were appointed with an In-Network provider. Tricare picks up the difference. Don’t wait for your appointment.
From: Susanna on: August 25, 2017
My dentist saw several of my children for a standard dental checkup and cleaning at the beginning of May. That day I was on the phone in the office trying to get contact information for the new contactor, United Concordia. UC has neglected to pay the claims initially citing they needed verification that our dentist was qualified. Then UC decided my 6 year old son's visit had to have been my active duty husband and diverted his claims to their active duty department and began sending us explanation of benefits statements showing they've denied his claim 3 times. The dentist's secretary has called, I have called, and my husband has called to alert UC of this error to no avail. To date, two of my five claims from early May have yet to be paid. My dentist told me the reimbursement rates aren't even half what they used to be. He is not a contracted provider, but had always honored the insurance rate. However, now the reimbursement rates are so low there's no way he can continue to see us without charging us some amount to recovery the loss he's taking by providing us care. He's a prior service military dentist who genuinely cares for his patients. He keeps his overhead cost low so as not to have to cost gouge his patients. We've been seeing him for almost 8 years. He personally cleans our teeth at every visit and spends a lot of time educating us on proper dental care. I'm not changing dentist. I'm very upset at how UC has treated our dentist.
From: Susan on: June 3, 2017
As usual Tricare, the Defense Dept., & the lowest bidder are all backing each other up. It's not about quality care for the soldier & his family. Going with the lowest bidder is not about putting quality first. Quality is always last because it's all about the money. They're always preaching about how important the soldier and his family is. This is a perfect example of how untrue that is.
From: Carinsa Phelan on: May 25, 2017
This article is correct with our dissatisfaction, however there is a huge change with the contract and it's not something that is families will just have to adjust to: insurance isn't paying crap! If we want to stay with our dentist, we have to fork over hundreds of dollars just for basic care for 4 dependents. We have been with our dentist for many years and they've watched our children grow and we've established not only trust but relationships. Now we have to go elsewhere, most likely a chain that offers poor care , because this contract doesn't pay crap. Military families make so many sacrifices and we can't even get quality care dental care. QUALITY DENTAL CARE!!
From: Scott on: May 25, 2017
Our dentists are like family because they treated my wife and kids the same way. Losing them as our dental provider was like moving again. Not fair this time. It needs to be fixed.
From: Kristine on: May 25, 2017
Good article. As I suspected, the real problem is with DHA and the bid specifications used for the new contract.
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