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Tricare to Cover Anesthesia Costs for Some Dental Beneficiaries

By Gerry J. Gilmore
American Forces Press Service

WASHINGTON, June 27, 2007 – 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 Activity’s dental care division, told American Forces Press Service.

“Those people who’ve received (dental anesthesia) care during that time can submit their bills to see how much of that will be covered,” Martin said. “All of this requires pre-authorization; you have to get pre-authorization from the regional contractor for Tricare.”

The new initiative doesn’t 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 Parkinson’s 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 dentist’s 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 “would make it difficult to treat them in a safe and effective manner in a regular dental treatment setting,” Martin pointed out.

Use of general anesthesia in dentist’s 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.

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

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