Google
What is Co-Managed Care for Veterans?

Start a Discussion

Get Involved and start your discussion now. Our members will discuss with you!

Start a Discussion

Subscribe to our Newsletter

* 
* 

Tricare approval for Dental anesthesia for disabled daughter

Military Authority Member
Irene Lopez August 22nd, 2012

I sent this message to tricare along with all the needed docs and they referred me to your site without approving or disapproving my request: My daughter is developmentally disabled. She needs anesthesia during dental surgery to be put to sleep with an anesthesiologist present in a hospital type setting in a Dental Office. Will Tricare help me with the cost for this service? This is the only way she can have the dental work done. It is a cost I cannot afford. Her Father is the sponsor and is retired military. We are divorced but she lives with me. He, she and I are all in DEERS.


Replies

Military Authority Member
Jason Van Steenwyk August 27th, 2012

Hello, Irene, and thanks for writing.

Unfortunately, we're just a media site. We have nothing to do with TRICARE and its coverages. In fact, it's extremely strange that TRICARE would refer you here. It doesn't make a lick of sense.

Nevertheless, we welcome the challenge!

On your specific issue, sedation dentistry is very common and well established as a medically necessary treatment for the developmentally disabled. And, as it turns out, TRICARE specifically covers it!

See this page.

http://www.tricare.mil/mybenefit/jsp/Medical/IsItCovered.do?kw=Anesthesia

In pertinent part:

TRICARE Covers:

Anesthesia services, supplies and sedation with or without analgesia (conscious sedation) when administered for a TRICARE-covered procedure.

Institutional and anesthesia services in connection with dental treatment for patients with developmental, mental or physical disabilities, or for pediatric patients age five and under.

You shouldn't have much trouble getting a claim approved if you point out this language on the Website - though you may need to show documentation showing your daughter has been formally diagnosed with a developmental disability by a medical professional in order to qualify for the coverage (unless she's age 5 or younger).

If you do get the runaround, here's a link to TRICARE's appeals and grievances page:

http://www.tricare.mil/mybenefit/ProfileFilter.do;jsessionid=Q7jWJzxS78X84Jy2s1ZSfm6617QsN131rDXJnSVpBnFwYfymqC0L!1658213750?puri=%2Fhome%2FMedical%2FAppealsGrievances

Hope that helps, and best wishes to you and your daughter!


Jason Van Steenwyk
Financial editor, MilitaryAuthority.com

Add Your Comments