Can I Use My United Concordia Dental Insurance in Mexico?

The type of plan you hold determines how the process works. Here is what you need to know about each plan type.

Commercial PPO Plans: Your Best Path to Reimbursement

If you hold a United Concordia commercial PPO plan through your employer, you very likely have out-of-network benefits that apply to dental treatment received in Mexico. United Concordia PPO plans have successfully processed out-of-country claims when submitted with complete documentation and proper ADA/CDT procedure codes. You pay upfront at the clinic in Tijuana, then submit your claim and receive a partial reimbursement, typically calculated against United Concordia's Usual, Customary, and Reasonable (UCR) fee schedule for your zip code.

Reimbursements may not cover the full amount you paid, since UCR rates are based on U.S. pricing. But even with partial reimbursement on top of Tijuana's already lower prices, the total out-of-pocket cost is often dramatically less than what you would pay at a U.S. dentist.

FEDVIP Plans: Federal Employee Members

United Concordia's FEDVIP plans are administered through the U.S. Office of Personnel Management for federal employees and their families. These plans are subject to OPM guidelines that generally require licensed providers operating within the United States for routine direct coverage. Out-of-country emergency care may be considered, but elective procedures such as implants, crowns, or cosmetic work performed in Mexico are typically not covered under the direct benefit structure. FEDVIP members should review their specific plan documents and contact OPM directly for guidance on out-of-country reimbursement eligibility.

HMO Plans: In-Network Only

United Concordia HMO plans are restricted to in-network providers only. Because no dental clinic in Tijuana is credentialed within a U.S. HMO network, HMO plan holders are generally not eligible for reimbursement on out-of-country care.

The process is straightforward for PPO members. Here is how to do it right.

Step 1: Confirm your benefits before you go. Call United Concordia member services and ask the specific questions listed below. Request a reference number for the call, and follow up through your member portal to get confirmation in writing.

Step 2: Get pre-authorization if required. For major procedures like implants or crowns, your plan may require pre-authorization before treatment. Submit this request early, ideally before you book your appointment.

Step 3: Receive your treatment in Tijuana. You pay the clinic directly at the time of treatment. Keep your payment receipt.

Step 4: Collect your documentation. This is the step most people overlook. The quality of your documentation is what determines whether your claim is approved. See the full checklist below.

Step 5: Submit your claim online. Log into your member portal at unitedconcordia.com, download the out-of-network claim form, attach your documentation, and submit. Most claims are processed within 30 days.

Ready to plan your treatment? Contact Border Care Dental and we will help you coordinate your appointment and prepare the documentation you need.

Getting reimbursed comes down to paperwork. Clinics that regularly serve U.S. patients understand ADA coding requirements, so confirm this before you book. You will need:

• An itemized invoice from the clinic listing each procedure with its ADA/CDT code (for example, D6010 for implant placement or D2740 for a porcelain crown)
• The treating dentist's full name, clinic address, and Mexican dental license number (cédula profesional)
• A completed United Concordia out-of-network claim form from your member portal at unitedconcordia.com
• Pre-authorization documentation if your plan required it for the procedure
• Proof of payment, such as a receipt or bank statement showing the transaction

Ask the clinic for all of this before you leave your appointment. Border Care Dental's partner clinic in Tijuana provides full ADA-coded invoices and dentist credentialing information as standard practice.

Call United Concordia member services and ask

• Does my current plan include out-of-network benefits?
• Are dental procedures performed outside the United States eligible for reimbursement?
• Is pre-authorization required for major procedures like implants or crowns?
• What percentage of the UCR rate will my plan reimburse for out-of-network care?
• What documentation is required to submit a valid claim?

Always request a reference number for the call and confirm the answers through your member portal.

Even before any reimbursement from United Concordia, patients seeking care in Tijuana typically save 50 to 70 percent compared to San Diego and broader U.S. pricing. When you add partial reimbursement on top of that, the value is hard to match.

Here are a few examples from our partner clinic's 2025 price list

• Restored dental implant (Ideal brand): $2,000
• Implant with extraction, bone graft, membrane, and restoration: $2,500
• Monolithic zirconia crown: $600
• All-on-4 full arch: $12,000

For the full breakdown, visit bordercaredental.com/pricing.

Want a personalized cost estimate based on your treatment needs? Contact Border Care Dental and we will walk you through what to expect and how to get the most out of your United Concordia benefits.

Have questions about your specific United Concordia plan, or want to know what treatment would cost at our partner clinic in Tijuana? Contact Border Care Dental. We help U.S. patients understand their options, prepare documentation, and coordinate appointments with our trusted partner clinic. Visit bordercaredental.com/contact.