How do I file a claim?

First, let’s define a claim. A “claim” is essentially a bill or receipt for a doctor’s visit, medical treatment, or prescription medication.

In most cases, your healthcare provider or pharmacy will send the bill directly to your insurance company, so you won’t need to file a claim yourself. However, if you’re billed the full amount and think your health insurance should help cover the cost, you’ll need to file a claim.

To file a claim, complete a claim form and mail it to your insurance company. You can usually find the form on your insurance company’s website. Be sure to include a copy of your itemized medical bill and any other requested documentation. An itemized bill lists all the care you received along with the related billing codes. You can ask your medical provider for an itemized bill. They’ll know exactly what you need.

Once your insurance company reviews and approves your claim, they’ll mail you a check. The amount will depend on the specific terms of your plan. It typically takes up to 30 days to review a claim, followed by up to another 30 days to receive your payment, although timing can vary by insurance carrier. It’s helpful to be patient, but you can always call your insurance company to check on the status of your claim.

If you have questions about completing the forms, contact your insurance company directly using the phone number on the back of your insurance card or on the claim form. You can also contact Stride’s Member Experience team if you need help navigating the process.