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Getting Care With TRICARE Active Duty Dental Program

SEPTEMBER 21, 2023 – Most active duty service members (ADSMs) get dental care at military dental clinics, also known as military dental treatment facilities (DTFs). However, some care can’t be completed at a DTF. In these cases, you get care from civilian dentists through the Active Duty Dental Program (ADDP).

To get civilian dental care, you must first get an appointment control number (ACN). If you see a dentist without an ACN, you may be responsible for the full cost of your dental care.

“ACNs are a way for the military to track civilian dental care and ensure service members’ dental health and deployment readiness,” said Doug Elsesser, program analyst with the Defense Health Agency’s TRICARE Dental Program section. “The Active Duty Dental Program won’t cover your dental care without an ACN.”

Getting an ACN is easy. Take a moment to learn how to get an ACN before you schedule dental care.

Q: Am I eligible for the ADDP?
A:
Yes, if you’re an ADSM remotely located in one of two service areas:

  • CONUS: The United States, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands
  • OCONUS: All other countries, island masses, and territorial waters

In CONUS locations:

  • You’re remotely located if you live and work more than 50 miles away from a DTF.
  • If you’re a non-remote ADSM, you can see a civilian dentist through the ADDP if you get a referral from your DTF.

In OCONUS locations, you must be enrolled in TRICARE Prime Remote Overseas to use the ADDP.

Remember to keep your Defense Enrollment Eligibility Reporting System (DEERS) record up to date. DEERS shows if you’re eligible for ADDP benefits.

Q: When do I need an ACN?
A:
You need an ACN before you get any care from a civilian dentist in CONUS and OCONUS locations.

However, you don’t need an ACN for emergency dental care, as described in the Active Duty Dental Program Handbook.

Q: I have an authorization or referral. Where can I find my ACN?
A:
Approved authorizations and referrals include your ACN. You can find it on your authorization or referral letter, available in your ADDP My Account.

Q: How do I get an ACN without an authorization or referral?
A:
You can get an ACN yourself for routine dental care that is:

  • A covered benefit
  • Less than $750 (U.S. dollars) per procedure or appointment
  • Not more than a total of ($1,500 U.S. dollars) for treatment plans completed within 12 consecutive months
  • Scheduled with a network dentist (CONUS)

If you need specialty dental care or care that exceeds the costs above, you need authorization from your civilian dentist.

There are two ways to request an ACN:

  1. Submit an ACN Request Form online (CONUS only). This is the quickest way to get an ACN.
  2. Call the ADDP contractor, United Concordia, at 866-984-2337 (CONUS) or 844-653-4058 (OCONUS).

Q: I have an ACN. How do I make an appointment with a civilian dentist?
A:
In CONUS locations, you can schedule an appointment with a network dentist or United Concordia can make one for you. If you have a DTF referral, your DTF can schedule your appointment.

In OCONUS locations, call United Concordia for help finding a TRICARE OCONUS Preferred Dentist (TOPD). A TOPD will:

  • File claims for you
  • Charge you only the cost-share at the time of service
  • Submit predeterminations before you get complex or costly treatment

You don’t have to see a TOPD, but if you don’t, you may have to pay for services up front and submit your own claims.

Have questions or need help getting care? Reach out to United Concordia. To learn more about the ADDP, see the Active Duty Dental Program Handbook and Active Duty Dental Program Brochure. For a full list of ADDP covered services, download the Benefit Details Document.

Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.

Courtesy Story
Defense Health Agency

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