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Disenrolling from TRICARE Dental Program

You can disenroll from TRICARE Dental Program by completing a new TRICARE Dental Program Enrollment/Change Authorization Form.*

Your coverage ends depending on when your form is received. See below for more details.

Date Application Received  Coverage Ends 
December 21-January 20 February 1 
January 21-February 20 March 1 
February 21-March 20  April 1 
March 21-April 20  May 1 
April 21-May 20   June 1 
May 21-June 20  July 1 
June 21-July 20  August 1 
July 21-August 20   September 1 
August 21-September 20  October 1 
September 21-October 20  November 1 
October 21-November 20  December 1 
November 21-December 20  January 1 

* Must meet 12-month lock-in except under certain circumstances.

TRICARE Enrollment Freeze

Starting Dec. 1 2017, there will be an enrollment freeze lasting approximately three weeks to allow the new TRICARE regional contractors time to transition your information. You will still be able to access care during the enrollment freeze. >> Learn more

Last Updated 4/27/2017

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United Concordia

CONUS: 844-653-4061 
OCONUS: 844-653-4060 
OCONUS Toll: 717-888-7400


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