TRICARE Retiree Dental Program

TRDP ended in 2018. To file a claim or grievanceYou can file a grievance when:
- You have a complaint about the quality of care you received,
- A provider or facility behaved inappropriately, or
- You have any other non-appealable issue.
The grievance may be against any member of your health care team. This includes your TRICARE doctor, your contractor, or a subcontractor.
for care received prior to Jan., 1, 2019, use the forms below.

 

Claim Form (United States)

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:

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

Claim Form (Overseas)

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:

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

Patient Grievance Form

Enrollee requests for Delta Dental to investigate grievances must be submitted in writing to the address below. The grievances must be documented on the reverse side of this form and must specify the grievance with requested outcome and any additional records, documents or billing information to support the grievance.

Delta Dental of California
Federal Services Division
P.O. Box 537015
Sacramento, CA 95853-7015

Last Updated 1/16/2019