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Dental Claim Forms

Active Duty Dental Program

United Concordia's network dentists will file a claim on your behalf. If you are approved to utilize a non-network dentist, you may be required to submit your own claim form.

Mail the Claim Form and supporting documentation to:

United Concordia
Claims Processing
P.O. Box 69429
Harrisburg, PA 17106-9429

TRICARE Dental Program

TRICARE Dental Program participating dentists will file claims on your behalf, but if you need to submit a dental, mail or fax the completed form and supporting documents to MetLife: 

Claims Submission Document (CONUS) 

TRICARE Dental Program
P.O. Box 14181
Lexington, KY 40512

Fax: 1-855-763-1333

Claims Submission Document (OCONUS)

TRICARE Dental Program
P.O. Box 14182
Lexington, KY 40512

Fax: 1-855-763-1334

For assistance, send an email to:

TRICARE Retiree Dental Program

Participating dentists will normally file claims on your behalf. If you must submit a dental claim form, send the completed the claim form and supporting documents to:

United States Claim Form

Deltal Dental of California
P.O. Box 537007
Sacramento, CA 95853-7007

Overseas Claim Form

Delta Dental of California,
P.O. Box 537006
Sacramento, CA 95853-7006
United States of America

Last Updated 12/9/2013