Tricare to Cover Anesthesia Costs for Some Dental Beneficiaries

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Tricare to Cover Anesthesia Costs for Some Dental Beneficiaries
June 27, 2007
By Gerry J. Gilmore
U.S. Department of Defense

ASHINGTON, June 27, 2007 Ò All Tricare eligible beneficiaries age 5 or under and beneficiaries with developmental, mental or physical disabilities will soon be eligible for anesthesia-cost coverage, a Tricare official said today.

The change becomes effective July 1 and some beneficiaries may be eligible for reimbursement retroactive from Oct. 17, 2006, which was when President Bush signed 2007 National Defense Authorization Act legislation that authorized the initiative, Air Force Col. (Dr.) Gary C. Martin, director of the Tricare Management ActivityÌs dental care division, told American Forces Press Service.

ÏThose people whoÌve received (dental anesthesia) care during that time can submit their bills to see how much of that will be covered,Ó Martin said. ÏAll of this requires pre-authorization; you have to get pre-authorization from the regional contractor for Tricare.Ó

The new initiative doesnÌt cover costs for dental work such as fillings or bridgework, Martin, a military dentist, said. Basic Tricare dental coverage does pay for twice-a-year dental examinations and teeth cleanings, he added. Beneficiaries can obtain dental insurance through Tricare or other carriers, he noted, to offset some dental-work costs.

Dentistry patients with disabling illnesses, such as ParkinsonÌs disease or Multiple Sclerosis, often require general anesthesia in order to perform dental work, Martin said. Also, young children who worry and fidget in the dentistÌs chair often must undergo general anesthesia before involved dental work can be performed, he added.

Not employing general anesthesia for individuals with certain physical or mental disabilities or young children Ïwould make it difficult to treat them in a safe and effective manner in a regular dental treatment setting,Ó Martin pointed out.

Use of general anesthesia in dentistÌs offices causes patients to temporarily lose consciousness, as opposed to the minimal, localized effect of a shot of Novocain, Martin explained. Also, the cost of dental anesthesiology is not inconsiderable, he added.

ÏNow, for Tricare-eligible beneficiaries, we can cover some or all of the costÓ for general anesthesia during dental operations, Martin said, depending on the level of coverage held by the beneficiary.