Thank you for submitting your claim. Our claims team will review your information and begin the claims process. It may be necessary to contact you for additional information. If at any time you have questions or need assistance, please give us a call at 1 (800) 754-3207.
Welcome to the Supplemental Health Claim submission process.
Please provide as much information as possible. All fields are required unless marked optional. A claim cannot be submitted without the required fields completed.
Be sure to click the “Next” button at the bottom of each page to save your information.
In the last step, you’ll be able to review and print all the information you’ve provided.
If at any time you have questions or need assistance, please give us a call at 1 (800) 754-3207.
You may also submit your claim by fax, email or mail by downloading, printing, and completing this form.