Submit a Claim Form

Personal Health Plan Members:

Your Personal Health Plan Member Portal is now live! You can use your Member Portal to submit your claims and track their status. 

Group/Employer Plan Members:

If you’re a group/employer plan member please log in to the Group Member Portal or download the Group Member app to submit your claims. Alternatively, you can submit a paper claim by downloading the form here.

Travel Claims:

For Travel Claims, please refer to the the Travel Assistance & Claims section here. For Disability Claims, please use the Disability documents section here.

Submit a Claim Form

We're working on enhancing your experience. The Submit a Claim form will be back up and running soon. In the meantime, you can log into your Member Portal here or submit a paper claim by downloading the form here.