What Every Veteran Should Know About Their Dental Benefits

Have you ever searched for a dentist who takes your insurance, only to find they’re booking six months or more in advance? Knowing what your insurance covers and what you and your family are eligible for can eliminate some of that work.

For veterans, the first step is understanding that enrollment in VA health care does not automatically mean you qualify for comprehensive VA dental care. The good news is that veterans have more than one way to access dental care. Some qualify for dental care directly through the Department of Veterans Affairs (VA), while others may be eligible to purchase private dental insurance through the VA Dental Insurance Program (VADIP).

Understanding the difference between these options can help you determine what you’re eligible for and what steps to take next.

VA Medical and Dental Eligibility Are Different

One of the most important things to understand about VA health care is that medical and dental eligibility are not necessarily the same.

A veteran enrolled in VA health care may have access to a wide range of medical services without automatically qualifying for ongoing VA dental care. The VA determines dental eligibility separately.

Depending on your eligibility, VA dental benefits range from limited treatment to comprehensive dental care. Some veterans may qualify for care related to a specific service-connected condition, while others may qualify for broader dental services.

Because dental eligibility can be complicated, the VA provides a current dental eligibility tool to help veterans determine whether they qualify.

Who May Qualify for Direct VA Dental Care?

VA dental eligibility is divided into several categories, and you don’t necessarily need to meet every requirement to qualify. Some of the major qualifying situations include veterans who:

• Have certain service-connected dental disabilities.
• Are former prisoners of war.
• Have qualifying service-connected disability ratings.
• Participate in certain VA rehabilitation or homelessness programs.
• Have a dental condition that is complicating another medical condition being treated by the VA.
• Are recently separated veterans who meet specific eligibility requirements and apply within the required timeframe.

These are only a few eligibility categories. Check the VA’s current requirements to see whether you qualify.

Watch the 180-Day Deadline.

Don’t wait. Recently separated veterans should pay particular attention to the application deadline. A 180-day deadline may apply to certain veterans who were discharged under qualifying circumstances.

If you think you may qualify under a recently separated veteran category, check your eligibility as soon as possible. Deadlines and requirements can depend on your circumstances, so verify the current requirements with the VA.

What Is VADIP?

If you don’t qualify for comprehensive dental care directly through the VA, you may still have another option: the VA Dental Insurance Program, or VADIP.

VADIP is private dental insurance offered at discounted rates to eligible veterans and CHAMPVA beneficiaries. It is different from receiving dental treatment directly through a VA dental clinic.

Generally, veterans must be enrolled in VA health care to be eligible for VADIP. Certain CHAMPVA beneficiaries may also qualify.

Unlike direct VA dental care, VADIP is insurance that you purchase. That means you’ll pay a monthly premium and may also have deductibles, coinsurance and other out-of-pocket costs, depending on the plan you choose.

When my husband retired, I had to figure out what dental care he and the rest of our family were eligible for. I quickly learned that finding coverage wasn’t just about the monthly premium. I also needed to consider which dentists accepted the plan and what services our family might need.

Coverage varies by plan, so look beyond the monthly premium and understand what’s covered and what you’ll pay out of pocket. Before enrolling, understand exactly what a particular plan covers and what you’ll pay.

Who Provides VADIP Coverage?

VADIP isn’t a single insurance plan—you have options. Delta Dental and MetLife are both participating VADIP providers.

Before choosing a plan, consider where you live, which dentist you want to use and the type of dental care you anticipate needing. Your best option may depend on where you live, which dentist you want to use and the type of dental care you may need.

If you have children who may need braces, pay particular attention to orthodontia coverage.

You can learn more about Delta Dental’s current VADIP coverage options and review its available plans and benefits directly.

What to Compare Before Enrolling

Choosing dental insurance based just on the monthly premium can be tempting – you want to save money when you can – but the cheapest plan isn’t always the least expensive option overall.

Before enrolling in VADIP, be sure to consider:

• Monthly premium: How much will you pay each month?
• Deductible: How much will you pay before the plan begins sharing costs?
• Annual benefit maximum: Is there a yearly limit on what the plan will pay?
• Coverage percentages: What percentage does the plan cover for preventive, basic and major services?
• Waiting periods: Will you have to wait before certain procedures are covered?
• Dentist network: Is your preferred dentist in the plan’s network?
• Out-of-network costs: What happens if you choose a dentist outside the network?
• Planned procedures: If you know you’ll need a crown, dentures, implants or other major dental work, how does the plan handle that procedure?
• Geographic availability: Is the plan available where you live?

If you’re comparing Delta Dental plans, you can compare benefits and costs before deciding.

Don’t Assume VA Health Care Includes Dental Care

Dental care can be easy to put off, particularly when you’re already managing other health care needs. But understanding your options doesn’t have to be complicated.

Start by checking whether you qualify for direct VA dental care. If you don’t, VADIP may provide another way to get dental insurance. Before choosing a plan, compare the costs, coverage and provider networks to find the option that works best for you and your family.

When I researched insurance options, I first checked with my orthodontist and dentist to see which plans they accepted. Then I compared the costs and coverage. After doing all that, I selected a plan, updated my insurance information with the offices and had a seamless transition.

Remember that you have options. Check your eligibility, understand your coverage and make that dental appointment you’ve been putting off.