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 http://www.trdp.org/downloads/claim-form-trdp.pdf.

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.

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Additional Information

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

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