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As a veteran, you are entitled to various benefits from the Veterans Affairs (VA) office. You may have already enjoyed perks such as health care and disability compensation. However, did you know that VA dental care benefits are also available?
Veteran’s dental care is designed to give retirees the same level of access to oral health care as civilians. It is important for all veterans, especially those who have served in combat areas, to take advantage of these benefits to maintain optimal oral hygiene and overall health.
Nonetheless, every Veteran should be aware of the nuances of VA dental benefits. In this article, you will learn about VA dental benefits and how to access them.
Health Benefits Included in Veteran Pay
Veterans enjoy a variety of health benefits thanks to the VA program. These include free medical care, mental health services, and disability compensation. These benefits encompass preventative, primary and specialty care, diagnostic, as well as inpatient and outpatient services.
Some of the most common services veterans use include routine checkups, physical exams, eye care, hearing tests and treatments, emergency services, hospitalizations, and surgeries. Check out this Veterans’ Benefits guide for more in-depth information. You should also know about the Affordable Care Act (ACA) for your VA care benefits.
Is There Free VA Dental Care?
The type of VA dental care covered depends on the specific situation. Generally, the VA covers preventive and diagnostic services such as exams, cleanings, and X-rays. Additionally, some therapeutic services like fillings and root canals may be covered depending on the Veteran’s circumstances.
However, some dental services are not covered by VA dental benefits. These include cosmetic procedures such as teeth whitening and veneers, orthodontic treatment, implants, and dentures. Suppose a veteran requires any of these services. In that case, they must pay out-of-pocket or seek coverage under a private dental insurance plan.
How Dental Benefits Differ From Other Veteran Medical Coverage
One primary difference between VA dental benefits and other forms of care for veterans is that the former typically cover preventive care, such as regular cleanings and exams. Other forms of medical coverage may not cover these services. Additionally, VA benefits are offered to service members who are retired or separated from the military. In contrast, some other types of coverage may not be available to those who have left active duty.
How To Apply for Dental Benefits
Here are the steps to apply for VA dental benefits:
Check If You’re Eligible
The disability application process starts with checking your eligibility for VA dental benefits. Generally, veterans who have a service-connected disability rated at 50% or higher and those receiving a VA pension may be eligible to receive these benefits. Additionally, veterans enrolled in the VA Health Care System for 24 months will qualify.
You’ll find the eligibility requirements in the next section.
Fill Out the VA Health Care Application Form
Fill out the 10-10EZ health care application form to apply for these benefits. You will need to prepare some documents for your application, such as:
• Social Security Numbers: You need to submit your number along with your spouse’s and qualified dependents’ numbers.
• Military Discharge Information: Provide a copy of your DD214 or other relevant separation documents to show your service. You can also sign in to the VA website and they may be able to retrieve this information on your behalf.
• Insurance Cards: You also need to notify the department about all the insurance providers that cover you. This includes coverage from your spouse or significant other and Medicare, private insurance, and employer insurance.
You may be asked to provide your household income and deductible expenses for last yearl to assess eligibility. Once you have all the necessary information, fill in the form and wait for the department to process your application.
Don’t worry about the security of your data since the VA Privacy Service preserves and protects the personally identifiable information of veterans and their families.
Find Dental Clinics Near You
Using the VA’s Healthcare Locator tool you can start looking for a VA-approved dentist near you. This will help you locate dentists near your area who accept VA coverage for care services. You can type in your city, state, or postal code to find eligible dentists in your area. Then, for the Facility Type, choose VA Health, and click “Dental Services” for the service you need.
VA Dental Benefits Eligibility Requirements
VA dental benefits depend on many factors, including military service history and lifestyle. Determining these can place you in a benefits class, which dictates your eligibility for dental benefits.
Class I
VA dental benefits are available to veterans with a service-related disability, certain income thresholds, and/or those enrolled in VA’s health care program. To qualify for Class I dental coverage, you must meet one of the following criteria:
• Have a service-related disability that has been rated as 100% disabling (temporary or permanent) by the Department of Veterans Affairs
• Receive aid and attendance or housebound benefits from VA
• Have a VA-rated service-connected disability of at least 50%
• Receive a VA pension
• Be enrolled in the VA health care program
Class I veterans are eligible for any VA dental care needed to restore or maintain oral health, including:
• Diagnostic and preventive care such as exams, x-rays, cleanings, and fluoride treatments
• Basic restorative procedures such as fillings and extractions
• Major restorative procedures, including crowns, bridges, and dentures
Note: Being paid 100% disabled veterans’ benefits due to long-term inpatient care, hospital stays, and rehabilitation renders you ineligible for Class I benefits.
Class II
Class II veterans are eligible for one-time VA dental care if their DD214 shows they could not complete their dental examination and all other dental treatments before discharge. Veterans under this category served during the Persian Gulf War era for 90 days or more and didn’t receive a dishonorable discharge. You must also apply for dental care within 180 days of discharge or release.
Note: You won’t be eligible for Class II outpatient dental treatment benefits if you received a dental award letter from VBA before 1955 notifying you that your dental conditions aren’t compensable.
Class IIA
Class IIA veterans are classified as such if they have a service-connected dental condition or disability. Therefore, they are eligible for any dental care necessary for functioning dentition. This includes preventive and restorative care, prosthodontic services, endodontics, periodontics, and oral surgery.
VA Teeth Disability Ratings
• 40%
A 40% teeth disability rating means that the Veteran has suffered extensive dental damage affecting their ability to perform everyday tasks. This could include difficulty chewing, speaking, or smiling due to the condition of their teeth.
• 30%
A 30% rating indicates a severe disability that requires treatment. This rating is given to veterans with missing teeth, gum disease, or other dental disabilities such as broken jaws and facial deformities.
• 20%
A 20% rating for VA teeth disability is given for the loss of a single tooth or multiple teeth due to decay, trauma, or surgical extraction and periodontal disease/gum disease that has caused loss of bone and soft tissue support around the teeth.
It’s also given for advanced periodontitis with extensive loss of bone and gum tissue that may lead to eventual tooth loss and severe malocclusion (teeth out of alignment), resulting in difficulty with chewing, speaking, or other dental functions.
• 10%
A 10% rating indicates that the Veteran has difficulty using their teeth for mastication or chewing. It is usually associated with other disabilities, such as a jaw injury. It may require surgical procedures like dentures to correct.
You should know that natural loss of teeth, such as through aging, is not ratable since the VA considers them easily replaceable by false teeth or bridges and dentures. They must result from an injury, accident, or disease connected to your service to be eligible.
Note: You need to have these documents: VA Form 10-564-D (Dental Trauma Rating) and VA Form 10-7131 (VA Regional Office Rating Decision letter) to determine the teeth that are trauma rated.
Class IIB
Veterans signed up for the Homeless Veterans Dental Program can receive one-time dental care to alleviate dental pain or help get a job. The dental care must also be for gingival and periodontal conditions, such as gum infections, which can’t be treated with over-the-counter medications.
Class IIC
Former prisoners-of-war (POWs) are eligible for full VA dental benefits, regardless of their service-connected disability rating. It’s important to note that eligibility is not based on the POW’s disability rating, but rather on their former prisoner-of-war status.
Class III
Class III dental benefits are eligible for veterans whose dental conditions are clinically determined to be associated with their time serving the country. This includes veterans with a dental condition caused by or aggravated by their service-connected disability and those with severe jaw deformities due to trauma or disease during service.
These benefits are generally provided for the diagnosis, relief of pain, surgery, restoration of teeth, and maintenance of dental health as needed. In some cases, prosthetic appliances may be covered under this benefit category if it is related to the service-connected disability.
Class IV
Veterans with service-connected dental conditions or those who receive TDIU benefits are eligible to receive Class IV dental benefits. This includes any necessary dental care, prosthetic devices, and oral surgery. Veterans must have been discharged under honorable conditions to qualify for this level of benefits.
Note: Receiving the 100% disabling rate based on long-term hospital stay or rehabilitation voids this benefit.
Class V
If you’re actively engaged in a vocational rehab program under 38 U.S.C Chapter 31 Veteran Readiness and Employment program, you’re eligible for dental care to meet the following goals:
• Staying and completing the rehabilitation program
• Rejoining the program quicker (if your participation was interrupted)
• Landing a job during the employment assistance period
• Becoming fully independent in your daily living
The Veteran Readiness and Employment program is available to Veterans with a service-connected disability rating of at least 20%. There are also other eligibility requirements, such as having an honorable discharge or being discharged due to illness or injury. It’s developed to help Veterans achieve their rehabilitation goals and increase employability.
Class VI
Veterans enrolled in VA health care are eligible for Class VI dental benefits. Their dental condition must be affecting their overall health and related to their military service. Additionally, it must be proven that their dental health is making it difficult to treat their overall condition.
What Is the VA Dental Insurance Program?
The VA Dental Insurance Program (VADIP) is a voluntary dental insurance program administered by the Department of Veterans Affairs. The program was established to provide eligible veterans and their families or CHAMPVA beneficiaries access to quality dental care. VADIP provides comprehensive, preventive, restorative, and emergency services within a network of participating dentists nationwide.
You’re not eligible for comprehensive dental care through a VA facility. However, VADIP may be an option for you. The program was designed to provide veterans access to quality dental care at a reasonable cost.
These are the discounted services that you can enjoy under VADIP:
Diagnostic Services
Under the VADIP plan, members can receive discounted services from any participating dentist in their area. In addition, participating dentists have agreed to provide discounted dental work for VA Dental Insurance Program members. This includes diagnostic services such as cleanings, X-rays, exams, and consultations.
Diagnostic services assess the overall condition of your teeth and gums. They can also detect any issues or problems requiring more in-depth treatment. These services are the first step in maintaining good oral health.
Preventive Dental Care
At a reduced cost, you can also enjoy preventative dental care services, such as biannual dental checkups and cleanings. This is a great way to keep your teeth and gums healthy so that you don’t need more expensive treatments down the line.
Similar to diagnostic services, preventative dental care encompasses X-rays, exams, and consultations to ensure your teeth and gums stay in great condition. You may also get sealants and fluoride treatments under this program.
Endodontic or Restorative Services
This service includes root canals, crowns and bridges, dentures, and other vital services. A few Veteran classes are eligible for these services. However, it would be best to take advantage of these under VADIP to get better value.
As mentioned, the loss of teeth due to aging isn’t covered. Still, any trauma or disease-caused loss of teeth is eligible for services under the program. That’s why you should consider the VADIP route if you are a veteran with dental problems that aren’t necessarily caused by your time in the service.
Endodontic services are useful for those with cracked or infected teeth. Not only do these services restore the aesthetics of your smile, but they also prevent further damage to bone and gum tissue.
Dental Surgery
Dental surgery may be required if you have severe gum disease, cavities, or other dental problems. This can include extractions, root canals, and other necessary treatments to restore oral health. It can range from minor procedures to major operations involving the jaw and facial bones.
Emergency Dental Care
Insurance comes in handy during emergencies when you have no time to plan or save money ahead. VA dental insurance coverage has your back in that case. At a discounted rate, it covers emergency services like tooth extractions, root canals, and even crowns or bridges.
You may need emergency dental care when you have a sudden toothache, gum infection, or fractured tooth. This insurance covers the cost of treatment and some necessary medications related to it.
On a side note, the Oregon Health Authority has recently lau
ched a Veteran Dental Program that offers free dental care for Oregon veterans. The Oregon health plan includes teeth cleanings, fillings, and extractions. So, if you’re an Oregon veteran, check it out.
VADIP Plans
VADIP has two major plans for veterans:
Delta Dental
The VA partnered with Delta Dental to provide comprehensive coverage for veterans and their dependents. Delta Dental covers routine exams, cleanings, fillings, root canals, crowns, bridges, and dentures. In addition to these basic services, the plan offers specialty care, such as endodontic treatments and orthodontia, at an additional cost.
Delta offers three types of plans: the Enhanced Plan, the Comprehensive Plan, and the Prime Plan.
Enhanced Plan
The Enhanced Plan covers 100% of diagnostic and preventative services for in-network clinics while offering up to 80% for out-of-network providers, such as Aspen Dental. Basic restorative fillings and simple extractions have 50% coverage for in-network VA dental professionals but only 30% for out-of-network dentists. This Plan doesn’t cover general services.
Comprehensive Plan
The Comprehensive Plan covers 100% of diagnostic and preventative services while offering up to 80% coverage for out-of-network providers. This Plan also covers basic restorative fillings at 60% for in-network clinics and 40% for out-of-network providers. For simple extractions and general services, such as crowns and bridges, endodontic treatments, and orthodontia, you can enjoy 50% for in-network providers and 30% for out-of-network clinics.
Prime Plan
Upon enrollment, you can enjoy full diagnostic and preventative services, such as routine cleanings, x-rays, oral exams, and sealants, with zero additional cost when you go to in-network dentists. For out-of-network dentists, you’ll have coverage of up to 90%.
The Prime Plan covers up to 70% of basic restorative fillings and 50% of simple extractions and general services for in-network providers. For out-of-network dentists, you can get up to 40% coverage.
Moreover, Delta Dental has additional benefits after nine months of enrolling in their plans. You can avail of services such as crowns, root canals, gum treatments, and prosthodontics with as much as 70% coverage depending on your chosen plan. This can greatly relieve veterans who need more advanced dental treatments.
MetLife
MetLife is another VA partner that offers VA Dental Insurance Program (VADIP) plans. These plans are available to all veterans, regardless of income or health status. MetLife provides various dental coverage options, including basic and major care and preventive services. The company also covers orthodontic and prosthodontic treatments if they are medically necessary for the Veteran’s oral health.
There are two MetLife dental plans:
Standard Option
The Standard Option includes cleanings, bitewing X-rays, and oral exams at full coverage for in-network providers. Otherwise, it’s only up to 60% covered. For fillings, periodontal maintenance, and X-rays other than bitewing, you’ll be 50% covered for in-network dentists and 40% for out-of-network ones.
Crowns, bridges, root canal treatment, and dentures will be covered by as much as 30% in the standard Plan, while 20% for out-of-network clinics. Unfortunately, this plan doesn’t cover comprehensive orthodontic treatment.
High Option
The High Option covers preventive services at a 100% rate for in-network providers and up to 90% for out-of-network dentists. That includes cleanings, bitewing X-rays, and oral exams.
Fillings and periodontal maintenance are covered by 70% and 60% for out-of-network dentists. It’s 50% for crowns, bridges, root canal treatment, and dentures when visiting an in-network provider and 40% for out-of-network ones. This plan also covers comprehensive orthodontic treatment at a rate of up to 50%.
FAQs
What extra benefits do priority group one Veterans receive?
Priority Group One is one of the top VA priority groups. It pertains to those who have a veteran service-connected disability, former Prisoners of War (POWs), or are receiving VA compensation for total disability. These veterans may be eligible to receive comprehensive dental coverage at no cost through the VADIP.
Does the VA pay for braces?
The VA typically does not pay for braces as a part of its dental benefits package. However, if the braces are related to a service-connected disability, they may be covered under other provisions.
How can I cover dental in retirement?
Retired from the military, you may be eligible for VA dental benefits. These benefits are available to veterans who served at least 90 days of active duty and have a service-connected disability rating of 10 percent or more. Moreover, according to the VA disability rates 2023, veterans who meet these criteria can receive up to $3,000 per year for their disability benefits.
How We Can Help At Benefits.com
If the entire process seems daunting, we’re here to help. Our team of professionals is well-versed in all areas of VA dental benefits and can guide you through the process from start to finish. In addition, we understand that navigating the system may be overwhelming, so we are available to answer any questions regarding eligibility, coverage, and filing claims.
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We’ve developed a straightforward process. First, you need to complete our short, free questionnaire so that we can learn more about your unique situation. Our team will then review your information and work quickly on helping you receive the benefits you’re entitled to.
Take the first step today. Allow us to help you secure the VA disability benefits you deserve.
