TRICARE Retiree Dental Program (TRDP)
 Overseas Claim Submission

ATTENTION: A TRDP Claim Form must be completed before attaching it to this submission form. A TRDP Claim Form can be obtained by clicking the link

Required Information

 /   /  MM/DD/YYYY
(use either your 9-digit SSN or 11-digit Defense Benefits Number, excluding hyphens and spaces)

Required File Attachments

All overseas claims submitted via this form MUST include a scanned image file of your 1) dentist's payment receipt along with your 2) completed TRDP Claim Form. Accepted image file types are pdf, jpg, jpeg, tif and tiff.


Additional Information

Enter any additional related information that may be helpful in processing your claim:

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