Claims

Go to Manage Claims to easily find your claims.

Individual & family plans

Submit a claim using the:

• Washington claim reimbursement form  (PDF document).
• Alaska claim reimbursement form  (PDF document).

Group plans

You can submit claims online, by signing in and using the claim submission form. If your plan includes out-of-network care, we will pay depending on the allowable amount for the services you receive, and that will also apply to your deductible and out-of-pocket maximum. You will be responsible for any remaining amount charged by the provider. Check your plan benefits for more detail.

It is usually 365 days from the date of service. If you are in an employer group and want to be certain, contact your benefits administrator. Otherwise, contact customer service.

The copay indicated on your card is the amount you will pay at your visit. (Copay is waived if you're directly admitted to an inpatient facility. Note that staying in the hospital on observation status is not the same as being admitted.) After we receive the claim, any emergency room charges greater than the copay will apply to your deductible. Any other services provided will apply to the appropriate benefit.

Note: HSA plans do not have copays, so you won’t see them on your card.

First, be sure you review your explanation of benefits statement carefully to make sure you understand how services are or are not covered for your care. If you have further questions, contact us. You can learn more about your rights and get appeals forms on the forms page.

Visits to check symptoms or to check you because of your family history are called diagnostic and are billed accordingly. Preventive screenings are done on a schedule to look for early signs of illness and are part of your plan benefits, at no added cost to you.