Filing a Medical Claim

If you visit a network provider, your provider should accept assignment of benefits.  This means that all network doctors (and some non-network doctors) will submit your claim to the Health Plan on your behalf and the Health Plan will reimburse your doctor directly.  In some cases, a non-network provider will not accept assignment of benefits and will require you to pay your entire claim up-front.  In those cases, you must file your claim with the Health Plan.

Each year, a Coordination of Benefits form is mailed to each participant during their open enrollment period.  If you have already filled out the Coordination of Benefits form and the information on the form has not changed, you do not need to re-submit this form to the Health Plan.  Otherwise, you should fill out the form and submit it to the Health Plan with your claim. The form is available here.

For detailed instructions on filing a medical claim with the Health Plan, please click on the type of claim that you will be submitting for reimbursement:

• Dental Claims

• Foreign Claims

• Hospital Claims

• Chemical Dependency and Mental Health Claims

• Professional Claims (e.g. a doctor's visit)

• Vision Claims

• Wellness Claims (e.g. flu shots, smoking cessation programs, etc.)

It is important that you mail your claims to the appropriate address detailed in the links above.  Claims that are incorrectly sent to the Health Plan office will be returned to you.

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