Enrollment
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Online
Please begin by reviewing the Application Guidelines prior to entering the online enrollment application. They will open in a separate window so that you can refer to them as you proceed through the online enrollment application.
To enroll online, you will need a Visa© or MasterCard©.
Due to documentation requirements, we are unable to accept enrollments on our website for Family-Member(s)-Only applicants. To enroll as a Family-Member(s)-Only applicant, please enroll by mail and enclose the appropriate documentation.
Online enrollment applications received by the last business day (Monday through Friday) of the month are effective the first day of the following month (provided your enrollment and prepayment information can be verified.).
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Please read the information below before accessing the online enrollment application to ensure you are charged the correct premium amount.
- Retirees residing in the 50 United States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa or the Commonwealth of the Northern Mariana Islands, please enter your 5-digit ZIP Code below. If you have an APO or FPO address, please use "00000" as your ZIP Code to return the correct premium rate.
- Retirees residing in Canada, please enter "99999" as your ZIP Code.
- Retirees residing outside of the 50 United States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, the Commonwealth of the Northern Mariana Islands and Canada, please enter "00000" as your ZIP Code.
Note: When completing the enrollment application, please use your mailing address, including international postal codes, APO/FPO addresses, etc. Do not use "99999" or "00000".
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Telephone
Call Customer Service Toll-Free at 888-838-8737 between 6:00 AM and 6:00 PM Pacific Time Monday through Friday and enroll with your Visa© or MasterCard©.
International Toll-Free
(AT&T USADirect Access Number*) plus
866-721-8737
(*For assistance with international dialing instructions, please visit www.usa.att.com/traveler/index.jsp)
Mail
| 1. |
Use the online premium search to determine your current premium prepayment. If paying premium prepayment by check or money order, please make it out to: TRICARE Retiree Dental Program. |
| 2. |
Download and print the TRDP Enrollment Application. |
| 3. |
Review the Application Guidelines found at the start of the TRDP Enrollment Application. |
| 4. |
Complete the TRDP Enrollment Application.
After completing the application, please double check that all signature lines are signed. |
| 5. |
Return signed and completed enrollment application and premium prepayment to:
Delta Dental of California
Federal Services
PO Box 537008
Sacramento, CA 95853-7008
United States of America
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