DENTAL

VA Dental Insurance Program (VADIP)

You may be eligible for VADIP if you meet one of these requirements.

One of these must be true:

Note: Insurance carriers may offer separate coverage options for dependents who aren’t CHAMPVA beneficiaries.

VADIP provides coverage throughout the United States and its territories, including Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands.

Why might I want to buy private dental insurance through VADIP as a Veteran?

While some Veterans enrolled in VA health care are eligible for free dental care from our providers, many are not. Others may be eligible for free care for some, but not all, of their dental needs.

If you’re not eligible for free VA dental care, VADIP can help you buy private dental insurance at a reduced cost.

If you’re eligible for free VA care for some of your dental needs, you can buy a VADIP plan if you want added dental insurance. Signing up for VADIP won’t affect your ability to get free VA dental care.

What types of dental care does VADIP cover, and how much will it cost?

VADIP plans cover many common dental procedures. These may include:

The costs for your coverage will depend on the insurance company and plan you choose. Please compare policies and benefits carefully. 

Based on your plan, you’ll pay:

10 WAYS TO QUALIFY FOR VA DENTAL

If you do not currently qualify for VA Dental, look into buying VA Dental Insurance Program (VADIP) through Delta Dental or Met-Life Dental. CHAMPVA beneficiaries can also qualify for VADIP. VADIP is not through the VAMC Dental office.


I

You have a service connected dental disability or condition for which you receive compensation (monthly payments) such as a jaw injury or condition like TMJ at 10% or more. You’re in: Class I.  You may qualify for: Any needed dental care

II

You served on active duty for 90 days or more during the Persian Gulf War era. You’re in: Class II. You may qualify for: One

time dental care if you meet all of the requirements listed below. Dental services may require multiple visits.

• You didn’t receive a dishonorable discharge, and

• Your DD214 certificate of discharge doesn’t show that you had a complete dental exam and all needed dental treatment before you were discharged

• You apply for dental care within 180 days of discharge or release, and



IIA

You have a service connected non compensable dental condition such as bruxism (grinding of the teeth) rated at 0% (a dental condition that you’re not getting disability payments for) or a mouth or jaw disability that’s the result of combat wounds or service trauma. You’re in: Class IIA. You may qualify for: Any dental care needed to make sure you have and can keep a functioning dentition (a working set of teeth). A Dental Trauma Rating (VA Form 10-564D) or VA Regional Office Rating Decision letter (VA Form 10-7131) will tell you the tooth/teeth/condition(s) that are trauma rated.

IIB

You are signed up to get care through the Homeless Veterans Dental Program (VHA Directive 2007-039). You’re in: Class IIB

 You may qualify for: A one time course of dental care that a VA dental care provider concludes you need to achieve at least one of the goals listed below. The dental care must be needed to:

• Relieve your pain, or

• Treat your moderate, severe, or complicated and severe gingival and periodontal conditions (gum infections that can lead to pain, swelling, and bone and tooth loss if not treated)

• Help you get a job, or



IIC

You are a former prisoner of war. You’re in: Class IIC.  You may qualify for: Any needed dental care

III

A VA dental care provider —working with your primary care provider— has concluded that your dental condition is linked to a service connected health condition and is making that condition worse. You’re in: Class III.  You may qualify for: Dental care to treat the oral conditions that a VA dental care provider concludes are directly making your service connected health condition worse. Your oral health might contribute to various diseases and conditions or service connected conditions or medications for service connected conditions may contribute to poor dental health, including:

• Endocarditis

• HIV/AIDS

• Cardiovascular disease

• Alzheimer's disease

• Respiratory diseases

• Other conditions that might be linked to oral health include eating disorders, rheumatoid arthritis, certain cancers and an immune system disorder that causes dry mouth (Sjogren's syndrome) or CPAP use.

• Diabetes


• Osteoporosis



IV

You have one or more service connected disabilities rated 100% disabling or you are TDIU (Total Disability based on Individual Unemployability or IU). You’re in: Class IV. You may qualify for: Any needed dental care. Please note: If you’re being paid at the 100% disabling rate based on a temporary rating (for a reason such as a long stay in the hospital or rehab care), that doesn’t qualify you for this benefit.

V

You are active in a 38 U.S.C. Chapter 31 Veteran Readiness and Employment (VR&E) program. You’re in: Class V - You may qualify for: Dental care that a VA dental care provider concludes is needed to achieve at least one of the goals listed below:

The dental care must be needed to:

• Make it possible for you to be in the employment program, or

• Help you get back to your employment program faster if you’ve had to stop (and are in “discontinued” status) because of an illness, injury, or dental condition, or

• Make it possible for you to reach the goals of your Veteran Readiness and Employment program, or

• Make it possible for you to get and adjust to a job during the period of employment assistance, or

• Prevent you from having to stop your employment program, or

• Help you get back to your employment program faster if you’ve had to stop (and are in “interrupted” or “leave” status), or

• Make it possible for you to be fully independent in your daily living

 


VI

You get VA care or are scheduled for inpatient care for a health condition—and you need dental care for a dental issue that’s making your health condition harder to treat. You’re in: Class VI.  You may qualify for: Dental care to treat the dental issue that a VA dental care provider finds is making the health condition you’re being treated for harder to treat

IP

 You currently get inpatient care in a hospital, nursing home, or other supervised homelike care setting (called domiciliary care). You’re in: Inpatient status. You may qualify for: Dental services that a VA dental care provider—working with your primary care provider—concludes you need to manage a health condition a doctor is currently treating you for.

 

NOTE: It is highly suggested that initially go through the Eligibility Office at your VAMC to establish eligibility. If you are registered with the VA dental through any of the dental programs and do not have an appointment with VA Dental every 36 months, you will need to re-establish eligibility.