You must have Javascript enabled to view the Navigation. No claims forms to fill out. However, on occasions due to travel and emergencies, you may have to use a non-network pharmacy and need to file a paper claim. Or you mistakenly paid full price for an in-network prescription.
Instructions Go to the claim form .
If you wish, you may fill in the claim form online. Print two copies of the claim form. If you did not fill in the form online, fill in by hand. Sign and date the certification statement in the area provided. Keep the other copy for your records.