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Extended Health Care Claim Please SEE REVERSE FOR DETAILS ON HOW TO SUBMIT YOUR CLAIM. IS THE CLAIM FOR DRUG EXPENSES ONLY? YES NO PART 1 Employee Statement Group Contract Number It is suggested that
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What is extended health care claim?
Extended health care claim is a request for reimbursement of expenses related to health services or treatments that are not covered by basic health insurance.
Who is required to file extended health care claim?
Anyone who has incurred out-of-pocket expenses for eligible health services or treatments and wants to be reimbursed for those expenses.
How to fill out extended health care claim?
Extended health care claims can usually be filled out online through the insurance provider's portal or by submitting a paper claim form with all the required documentation.
What is the purpose of extended health care claim?
The purpose of extended health care claim is to recover the costs of health services or treatments that are not covered by basic health insurance.
What information must be reported on extended health care claim?
Information such as date of service, description of service or treatment received, cost of service, and any receipts or invoices related to the expenses incurred.
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