VA Dental Insurance Program Overview (VADIP) – Dental Care for Veterans
The rising costs of dental services across the United States sometimes deter individuals — especially older people — from visiting the dentist, even in cases of emergency. The fear of hefty co-pays or having to pay in-full for pricey services such as crowns, bridges, or implants can dissuade many from seeking the treatment they genuinely need. In order to make dental care more accessible (and affordable) for veterans and their eligible family members who do not qualify for the VA’s more comprehensive dental benefits, the Department of Veterans Affairs offers a Dental Insurance Program, more commonly known as VADIP.
First rolled out in 2013 as a pilot program, VADIP has since been extended until Dec. 31, 2021 (and will likely be further extended). VADIP allows eligible veterans to purchase discounted dental insurance through two private insurance companies, thereby reducing its overall cost.
This article provides an overview of the VA’s Dental Insurance Program, including eligibility criteria, covered services, approximate costs, and plan options.
VA Dental Insurance Program Eligibility Criteria
VADIP was designed for veterans who do not have access to dental insurance. So you may be fine if you are already covered under FEDVIP, the military retiree dental insurance program.
Veterans who are enrolled in Veterans Affairs healthcare and eligible family members who are enrolled in the Veterans Affairs Civilian Health and Medical Program (CHAMPVA) are eligible to purchase discounted dental insurance through VADIP. Eligibility can be verified online, by calling 1-877-222-VETS, or by speaking with the enrollment coordinator at your local Veterans Affairs medical facility.
Keep in mind that dependents are not immediately eligible for VADIP; they have to be beneficiaries of CHAMPVA in order to qualify.
Also, veterans who purchase discounted insurance through VADIP may still be eligible to receive VA dental services and treatment, so it’s advisable to familiarize yourself with VA dental benefits that you may be eligible for before enrolling in VADIP.
Finally, veterans hoping to purchase dental insurance through VADIP must be located in the United States, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, or the Commonwealth of the Northern Mariana Islands. VADIP is not currently available for veterans or their family members living overseas.
What Dental Services Are Available through VADIP?
Depending on the VADIP plan selected (they range in coverage and cost), the following dental services are traditionally included:
- Diagnostic services (e.g. oral exams, screenings)
- Preventive services (e.g. dental cleanings, x-rays)
- Simple extractions
- Endodontic (i.e. root canals) and other restorative services
- Surgical services
- Emergency services
- Orthodontic services (*coverage depends on the plan selected; may be available for dependent children up to their 19th birthday)
Every participant enrolled in VADIP will pay a fixed monthly premium for coverage, which varies based on geographic location as well as status (e.g. veteran or CHAMPVA beneficiary), and any co-payments required by the selected plan.
Overview of Available Dental Plans
Currently, there are two private insurance companies that provide VADIP services: Delta Dental and MetLife. MetLife provides two VADIP options, while Delta Dental offers three.
MetLife is one of the world’s largest insurance providers and also has one of the United States’ largest dental provider networks with over 370,000 VADIP-participating dentist locations, making it relatively easy to find a participating location near you. It offers two VADIP plans, Standard and High.
The Standard option is a basic plan that offers more limited coverage for a lower annual deductible ($50 per plan participant) and a lower annual maximum per person ($1,000-$1,500 per plan participant, depending on whether the provider is in- or out-of-network). The Standard plan covers 100% of cleanings, bite-wing x-rays, and oral examinations with an in-network provider, making this plan an affordable and practical option for those seeking routine preventive care.
The High option is a more expensive option, with an annual maximum per person ($3,000-$3,500 per plan participant), but the annual deductible is $0 for in-network services ($50 per person if out-of-network). The main differentiator of MetLife’s High option is greater coverage for all services as well as 50% coverage for orthodontic treatments — which may be important for families with children under the age of 19.
Monthly premiums range from $28 to $194 depending on the plan selected (Standard vs. High), status (veteran vs. CHAMPVA beneficiary), geographic location, and the number of individuals being insured (a single veteran vs. a family of three and larger).
Although out-of-pocket expenses will be minimized by seeking care from an in-network provider, MetLife VADIP beneficiaries can choose to visit any licensed dentist and receive benefits for covered services.
Finally, since there is no ‘open season’ to enroll in MetLife’s VADIP plans, eligible veterans and family members can sign up year-round either online or by calling 1-888-310-1681. However, once enrolled in MetLife’s VADIP plan, you and your eligible dependents must remain in the plan for 12 months (a “lock-in period”) before making any changes.
Delta Dental, headquartered in California, currently offers three VADIP options: Enhanced, Comprehensive, and Prime. While all plans offer 100% coverage on preventive and diagnostic services for in-network dentists, they differ in their monthly premiums and expansiveness of coverage.
The Enhanced plan offers a basic level of coverage at a lower monthly premium —optimal for people who go to the dentist twice a year for routine care.
The Comprehensive plan offers a greater level of coverage for more common procedures such as root canals and tooth extractions.
In addition to sharing a name with a Tricare coverage plan, the Prime plan offers the highest level of coverage for major (often expensive) procedures such as crowns and implants. However, some benefits are only available after a 12-month enrollment period, such as crowns, root canals, periodontics, bridges, and implants.
Delta Dental’s monthly premiums range from $21.50 to $169 depending on the plan selected (Enhanced, Comprehensive, or Prime), status (veteran vs. CHAMPVA beneficiary), geographic location, and the number of individuals being insured (a single veteran vs. a family of three and larger).
Annual deductibles are comparable to MetLife: $0-$50 per individual depending on the plan selected and whether or not the provider is in-network (deductible is waived for diagnostic and preventive procedures for all plans).
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