Member Services

Member Customer Service

Claim Reimbursement

First, you need to obtain a copy of your Major Medical EOB (Explanation of Benefits) and Itemized Statement from your healthcare provider, showing procedures performed.

1. Typically, the EOB can be found online via your primary insurance carrier’s portal and/or may be receive via mail.
2. The Itemized Statement (or HCFA) can be obtained from your physician’s office/hospital of care.
3. You will also need to complete an OptiMed Claim Form which can be downloaded by clicking the button below.

Online OptiMed Claim Form

Once you have obtained these items and completed the OptiMed Claim Form you may file the claim to OptiMed via fax or by mail: