Medical Claim and Prescription Reimbursement Forms

There are generally two types of claim forms: a medical claim form, or a prescription drug reimbursement form. Here's a quick comparison:

Medical Claim Form

A medical claim form is used for services rendered where the provider either did not submit the claim to the carrier directly (which is often the case with out-of-network providers), or in situations where an enrollee needed access to care while waiting for their insurance application to be processed with a retroactive effective date.

Prescription Drug Reimbursement Form

In the event a prescription needs to be paid for out-of-pocket, a prescription drug reimbursement form can be used to receive a refund for any overpayments made for covered prescriptions.

How To Find A Claim Form

Forms can be found on the carrier's website. You can get direct access to your carrier's website via your Medical Overview page. Simply click on the Member Services & Claims Information link to get the website. 

If you need assistance submitting a claim, contact your insurance carrier or broker.