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Who Qualifies For VA Dental Care? (Ultimate Guide)

Who Qualifies For VA Dental Care? (Ultimate Guide)

You served your country well and risks your life to make sure we’re safe. You saw combat or dealt with prisoners of war. Now, you have a toothache. You might be curious about the VA Dental Insurance Program and whether you’re eligible for help.

If you worked in the Armed Forces, you’re probably curious about what dental conditions you can fix. Our guide will tell you about the dental benefits that come with being a serviceperson in the military.

What is VA Dental Care?

VA Dental Care is part of the VA Care umbrella. This is a specialized program that offers free or deeply-discounted dental services for qualified veterans. Like all VA Health Care, the dental care given is offered at a VA hospital or dental office.

What makes you eligible for free or discounted dental care through the VA?

The VA has pretty strict standards on eligibility, but they generally have a lot of leeway. They take things on a holistic basis. The most notable ways to qualify include:

  • Receiving a VA pension
  • Being enrolled in a VA healthcare program
  • Being a former prisoner of war
  • Having service-connected disabilities that involve you getting medical compensation
  • You’re unemployable and/or have 100 percent disability
  • Having a VA doctor note that you need dental treatment related to a service-related condition
  • You get VA care and the dental issue is making an underlying health condition harder to treat
  • Your mouth has been on the receiving end of service trauma, such as a dislocated or broken jaw. (You may need to get VA Form 10-564-D or VA Form 10-7131 for this.)
  • Having a service-related dental disability that interrupts daily living
  • Being diagnosed with service-connected conditions as a result of combat wounds or illness related to combat that requires regular dental care
  • ​​​​​Being signed up to get care through the Homeless Veterans Dental Program, also known as the VHA Directive 2007-039

There are other ways to qualify for free or discounted dental care, but these are the most commonly-cited reasons to qualify for free care or discounted care. In most cases, you will be able to qualify for aid in functioning dentition if you have a service-connected disability.

PRO TIP – Each qualification comes with a specific classification with specific eligibility results. You should know your class. Class II will not get the same care as Class I.

What can disqualify you from getting VA Dental Care?

What can disqualify you from getting VA Dental Care

VA Dental Care might give you a lot of options for care, but it’s possible to get disqualified for it. There are several reasons why you might get disqualified, including the following:

  • You have a dishonorable discharge. This is a discharge that occurs as a result of bad behavior while you’re enlisted, including committing crimes, going AWOL, or otherwise being a detriment to your team.
  • Your benefits aged out. This happened to people who were on active duty in the Persian Gulf War for at least 90 days. If this is you, you may get some benefits. However, you would have to reapply within 180 days of your release.
  • Your active duty or inactive duty was just considered to be part of the training. If this occurred, then it’s not really considered to be active duty. Sadly, while you may have put in the effort, you will not get the benefit if this happens.
  • You only qualified for a one-time dental correction under your categorization and have used that one-time shot. If your benefits have run out, then you’re not going to get your teeth fixed for free at a discount.

If you have been disqualified from getting benefits as part of your duty, you might be able to appeal it. However, the chances of getting the appeal approved can vary greatly. In the event of a dishonorable discharge, it’s almost impossible to get any benefits as a veteran.

How do I ask for VA Dental Care?

In order to apply for discounted care, you are going to have to contact the Department of Veterans Affairs. You can fill out a form online, reach out to the VA Health Care service via phone, apply in person, apply via mail, or talk to a VA application expert.

PRO TIP – If you are claiming total disability, you may want to ask for another beneficiary to help you connect to the right person. They and an application professional can help you apply for VA Dental Care benefits.

What kind of services can you get through VA Dental Care?

VA Dental Care services really vary greatly depending on what they qualify you to get. Here’s what you need to know:

  • People who have full VA dental coverage can get anything from checkups to dentures to restorative procedures covered in full.
  • If you don’t qualify for VA dental coverage but do have VA healthcare, any sort of oral surgery linked to a service-related health problem or a physical disability will be covered.
  • Most people who qualify will be able to get X-rays, a complete dental examination, and diagnostics for free.
  • A good rule of thumb is that the VA will try to get you as much dental care as you need in order to have as much independence as possible.
  • If you have a noncompensable dental condition, you may not be able to get VA Dental Care at all.

What should qualified applicants know about VA Dental Care before they sign up?

What should qualified applicants know about VA Dental Care before they sign up

VA Dental Care is not a free-for-all when it comes to dental work. The goal behind it is to offer veterans and families the maximum independence they can get without breaking the bank. Here’s what other perks you should know:

  • Dental care is not considered to be a guaranteed benefit for being part of the US Military. If you get the benefit, great. If not, well…There’s not much you can do about that. It’s not guaranteed, though it should be.
  • Almost 85 percent of veterans do not qualify for VA Dental Care. You have to be almost 100 percent disabled or otherwise given a one-shot deal to be able to qualify. If you aren’t qualified according to the current standards, you are not alone.
  • The treatment that you get will have to be at a VA dentist or a VA-approved hospital. Because it is a form of veteran benefits, most of your work (including an exam) will be done in a VA hospital. You will need to cover your own travel fees.
  • Your needed dental care may only be a one-time thing. Many VA benefits are only meant to be a one-off. If you are in a vocational rehabilitation program, the dentistry you get may be an investment in your future independence.
  • You need to have a backup plan. This can include applying for VADIP or even just doing some medical tourism to get your teeth fixed.

What is the VA Dental Insurance Program?

What is the VA Dental Insurance Program

The VA Dental Insurance Program, or VADIP, is one of the most popular benefits that the Armed Forces has to offer. This program offers discounted private dental insurance to all veterans and their family members.

Who can apply for VADIP?

The VA Dental Insurance Program is offered to veteran or beneficiary who is not qualified for free or discounted dental care through the VA. If you qualify for free VA dental care, you can still get VADIP if you want additional insurance for one reason or another.

VADIP tends to be particularly useful for children of veterans as well as spouses who need dental coverage. ChampVA beneficiaries of all walks of life can apply for VADIP. It’s a good perk that can save thousands per year.

What kind of insurance can VADIP offer you?

For the most part, the dental coverage you would get through a state marketplace is going to be the same type of coverage you’ll get through VADIP. As of right now, you can choose between two main providers: Delta Dental and Metlife.

What does VADIP cover?

The VADIP plans are fairly rudimentary. They tend to cover the basics, including:

  • Preventative care and diagnostics
  • Oral surgery like tooth extractions
  • Root canals and other oral health treatments
  • Emergency dental care

Basically, it’s a kit that helps reduce the money you have to spend to get a clean smile. Most programs will also offer a free cleaning and checkup every year.

When in doubt, ask a VA benefits manager.

There are a lot of benefits you can get as a veteran of the US Armed Forces. Some are guaranteed, others are not. Either way, being a servicemember is the easiest way to make sure that you get to keep your smile for years to come.

With a quick call to the Department of Veterans Affairs, you can find a way to get the coverage you need…or at least learn a way to get your stuff paid for.