Magazine article The Exceptional Parent

Dental Care for Special Needs

Magazine article The Exceptional Parent

Dental Care for Special Needs

Article excerpt

Whether it's from autism, cerebral palsy or muscular dystrophy, sometimes your family member needs dental work because of a medical condition.

And TRICARE may cover you-without the need to purchase anything else. The benefit is called "adjunctive dental care." Through this benefit, TRICARE may cover medically necessary dental work to help treat a covered condition. That includes dental trauma from preparation for, or treatment of, an injury or disease caused by the treatment of a covered medical condition.

Some examples of the adjunctive dental care TRICARE Prime may cover are:

* Removal of teeth and tooth fragments to treat and repair facial trauma from an injury

* Treatment of a condition called "full ankyloglossia"- or complete tongue-tie-to ease feeding, swallowing or speaking difficulties

* Dental or orthodontic care to correct a condition related to a severe birth defect

* Dental care to prepare for, or as a result of, radiation for oral or facial cancer

Before you can receive any adjunctive dental work through TRICARE, your medical care provider needs to receive authorization from your regional contractor. Your regional contractor is the company that administers your TRICARE health benefits. To find your contractor, visit

If the dental work is due to an emergency, such as facial injuries from a car accident, you won't need that authorization beforehand.

Routine Dental Care

When trying to determine if your family member may qualify for the "adjunctive dental care" benefit, you should know this: The regular TRICARE medical benefit does NOT cover routine, preventive, restorative, emergency non-adjunctive dental, prosthodontic or periodontic care that's not related to a medical condition. …

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