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Philpott: Tricare shifting dental coverage to new insurer

By: tom philpott Military Update
April 23, 2017 Updated: April 25, 2017 at 7:54 am
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Responsibility to provide dental care coverage to 1.37 million active duty family members, and 376,000 Reserve and Guard members and their families, will shift May 1 from MetLife to United Concordia Companies of Harrisburg, Pa.

The change in Tricare dental program contractor will bring lower patient premiums and a modest expansion of covered services. However, United Concordia also will lower key reimbursements to dentists below what they have been paid, prompting some dentists to warn patients they won't be joining the new network.

So, starting next month an unknown number of Tricare enrollees will need to find new dentists off a directory of participating providers that United Concordia began to build after it won the competitive bid contract last year.

Beneficiaries are accustomed to having to switch health care providers from time to time, usually when they move to new assignments or when support contracts expire and a new company wins the business.

With Tricare dental, family advocates say they have several concerns. One is whether United Concordia, by lowering some payments to network dentists, will create coverage gaps in some areas. Another worry is that lowered payments could impact the overall quality of the network provider pool.

A third concern is that the Find-a-Dentist directory run by United Concordia lists too many dentists who have decided, or might soon, not to participate.

Karen Ruedisueli, deputy director of government relations for National Military Family Association, said she used the directory atuccitdp.com to find general dentists within 10 miles of the 66027 zip code for Fort Leavenworth, Kan. Of 12 names that popped up, the two nearest said they would not participate. Of the other 10, two in Lansing, the next town over, said they had just switched management and would not be participating. And an office worker for two more dentists in Platte City, still a reasonable drive away, told Ruedisueli that United Concordia is cutting rates so significantly they probably would leave the network.

"United Concordia is making the argument that although families may have to switch providers, they will still have access to dental care," Ruedisueli said. "I would contend, however, that we are seeing a pretty significant shrinking of the network, at least in certain areas and maybe overall. It's just really early to tell."

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