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Dental Care for Veterans: Benefits, How to get VA Coverage, and More

by Dec 1, 2024General Dentistry

Veteran dental care benefits

Key Points

According to a report by the advocacy organization American Institute of Dental Public Health, veterans’ dental health is significantly worse than the general population’s. For instance, more than half (56 percent) of veterans have active tooth decay, a much higher incidence than in the regular population (37 percent).1

Roughly 2 in 5 — or a total of 8 million — veterans report their dental health as “suboptimal.” These grim numbers are attributable to many factors, but the main one is access (or lack thereof) to regular dental care.

This article covers the basics of dental care for veterans, including the various avenues for accessing coverage. It explores available options through the U.S. Department of Veterans Affairs (VA), along with related qualifying criteria. Keep reading to find out which approach may be right given your circumstances and dental health goals, along with some information on how to find the best VA dentist Greenville has to offer.

Table of Contents

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      The Problem: Veterans Lack of Dental Coverage

      Like other healthcare services, the cost of dental care has been increasing across the United States. For people with dental insurance, these changes may seem negligible, and even go overlooked. For those paying out of pocket, it is a different story.

      Many veterans receive health benefits through the U.S. Department of Veterans Affairs (VA). However, these programs do not necessarily cover dental services. That means that many veterans fail to receive regular dental checkups, cleanings, and other preventative services that contribute to oral health.

      There are other problems beyond not accessing preventative dental care. Veterans are more likely to miss work or suffer declines in productivity due to dental issues.

      Unsurprisingly, lack of coverage drives veterans to more costly emergency dental services, which total $1.7 billion annually. Across the board, veterans pay an average of 65 percent more in out-of-pocket dental costs than non-veterans.2

      What Is the VA Dental Insurance Program?

      The VA Dental Insurance Program (VADIP) refers to a federal program run by the VA that offers discounted private dental insurance to veterans and their family members, should they meet certain requirements. VADIP began as a temporary program but was made permanent by the Expiring Authorities Act of 2021.3 (If you were enrolled in the pilot program, you need to reenroll in the new, permanent version.)

      Who Qualifies for VA Dental Care for Veterans?

      Until recently, only veterans who had service-related dental issues or met a few other very narrow criteria were eligible for VADIP coverage. In fact, according to a report by the VA in 2019, of the 9 million veterans in the United States qualifying for VA medical care, only a little over 900,000 (or 1 percent) qualified for dental care as well.4

      However, another 2021 piece of federal legislation, the Dental Care for Veterans Act, changed that. It expanded eligibility for veterans to anyone enrolled in a VA health care program. Note that veterans who do have a service-connected dental disability still qualify for free dental care through the VA (and need to opt for that rather than VADIP, since they are ineligible for the latter).5

      Veterans also can enroll their family members in the VADIP. Dependents who are eligible for the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) can enroll in VADIP through their eligible guardian.

      Does VADIP Provide Free Dental Work for Veterans?

      VADIP is not free. However, it allows veterans and other qualified enrollees to purchase significantly discounted insurance plans through two companies: Delta Dental and MetLife. As with other private insurance policies, beneficiaries are responsible for paying plan premiums as well as any copayments associated with specific treatments or procedures.

      How Much Does VA Dental Cost per month?

      Like with any private health insurance, out-of-pocket costs — including premium levels and copays — will depend on the parameters of the policy. In general, premiums for both MetLife and Delta Dental plans will vary depending on the level of coverage you select. Geographic location and the number of people enrolled in a plan also can impact premium levels.

      You can find plans with monthly premiums under $30. Higher-tiered plans can reach close to $200 per month.

      What Does VADIP Cover?

      VADIP has policies purchased through MetLife and Delta Dental that cover most dental procedures. These include:

      • Diagnostic services
      • Preventive dental care
      • Endodontic or restorative services (including root canals)
      • Dental surgery
      • Emergency dental care

      Diagnostic services and preventative dental care fall into the category of general dentistry. This includes things like oral exams and screenings for dental issues. It also refers to preventative care like regular dental cleanings and X-rays, which can be used to diagnose and treat a variety of oral health issues.

      Endodontic and restorative services refer to root canals, crowns, and implants. It extends to dentures, bridges, and veneers.

      Common dental surgeries include tooth extractions and bone grafting. These can also involve things like corrective jaw surgery, bone grafting, or similar invasive procedures.

      As with any private health policy, there will be both in- and out-of-network dentists with either of the two insurance companies veterans choose. Both companies’ websites make it simple to search for in-network providers.

      MetLife

      MetLife is one of the world’s largest insurance companies. It also has one of the most expansive dental provider networks, with more than 370,000 participating dentist office locations.

      The company offers two options for coverage: standard and high. The standard plan covers 100 percent of cleanings, oral examinations, and x-rays with in-network providers, and 60 percent of costs incurred at out-of-network providers. It pays for up to $1,300 to $1,500 (depending on if the services are in- or out-of-network) per participant every year and has an annual deductible of $50 per beneficiary.

      MetLife’s high option has an expanded annual cap of $3,000 to $3,500 per plan participant. It also has a $0 deductible for in-network services and $50 per person for out-of-network care.

      The high option has farther-reaching coverage to include most dental services, including surgeries or other procedures that require sedation. It also pays for 50 percent of orthodontic treatments.6

      Delta Dental

      Delta Dental is headquartered in California and currently serves more than 90 million Americans. It has one of the largest networks of dentists across all 50 states, Washington D.C., and Puerto Rico.

      Delta Dental has three main coverage levels: enhanced, comprehensive, and prime. The enhanced plan is the most basic and covers routine cleanings and checkups. The comprehensive plan expands coverage to more in-depth procedures, like root canals and tooth extractions.

      Delta Dental’s prime plan has the highest premiums but the lowest out-of-pocket costs. It also has the most expansive coverage areas, including everything in the other two plans, along with surgical procedures, such as crowns and implants. Note that some of these are only available after a nine-month waiting period.7

      How to Enroll In a VA Dental Plan

      There is no “open enrollment” for VADIP, so eligible veterans can sign up at any time during the year. Once they have chosen an insurance provider, they can apply through their respective websites. Along with personal information, applicants should be prepared to provide their VA health care or CHAMPVA enrollment details.

      Once an application is approved, participants can start paying premiums and accessing benefits. Both companies have the option of automatic deductions, which can help ensure coverage is uninterrupted.

      Other Coverage Options

      Given the range in premium prices of VADIP, veterans should consider other options to pay for dental procedures. In many cases, reputable dental offices will offer in-house payment plans for basic dental services.Instagrin Logo

      At ProGrin, we partner with InstaGrin to provide a Dental Savings Program to all of our patients. Participants pay a nominal monthly fee of $25 per month, which covers basic dental procedures, including:

      • Two cleanings per year
      • Two dental exams per year
      • Unlimited X-rays

      Those services alone would cost at least $1,000 out-of-pocket. Also, if you require treatments beyond these, you will receive 20 percent off the cost of those by being enrolled in the program.

      This plan is a simple, straightforward, and economical alternative to traditional insurance, especially for someone who mainly needs routine dental care. There are no deductibles, claim forms, or concerns about pre-existing conditions.

      In addition, there are no waiting periods for coverage and you are guaranteed access to a dedicated doctor at all times. View enrollment and coverage details at this link.

      Learn More About VADIP and Dental Insurance for Veterans

      Increasing available dental health access is vital for the overall health and well-being of America’s veterans. Programs like VADIP are an invaluable tool for many veterans and their families. With so many options in terms of coverage, premiums, and out-of-pocket costs, you can be sure to find one that fits your dental health needs and budget.

      ProGrin is a premier dental provider that offers a comprehensive range of services, including general, cosmetic, restorative, and pediatric dentistry at 9 dentist offices in Greenville and throughout the Upstate. We do implants and other surgical procedures that involve sedation on-site. We also have an emergency dentist in Simpsonville and several other locations.

      Reach out to us today to learn more about low-cost or free dental care for veterans or to schedule an appointment.

 

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