Disenrolling from TRICARE Dental Program
You can disenroll from TRICARE Dental Program at any time 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 |