How to file a claim

To file a claim, simply submit a completed and signed Claim Form. Itemized verification for each expense must be attached. Detailed instructions are contained on the back side of the Claim Form. You can submit claims via e-mail, fax, or regular mail.

You may request reimbursement of qualified healthcare expenses and/or insurance premiums you have incurred on behalf of yourself, your spouse, and your eligible dependents. Qualified expenses and premiums submitted for reimbursement must have been incurred after you became a participant eligible to file claims.

Please note the following:

#1. Insurance premiums paid by an employer, or premiums that are or could be deducted pre-tax through your or your spouse’s section 125 cafeteria plan, are not eligible for reimbursement.

#2. If you or your spouse have a section 125 healthcare flexible spending account (FSA), you must exhaust the FSA benefits before submitting claims.

#3. Claims for over-the-counter (OTC) medicines and drugs should be for reasonable quantities expected to be consumed within a reasonable period of time. Sales tax can be included.

For ongoing insurance premiums, request systematic reimbursement by submitting a Systematic Premium Reimbursement Form. Or, skip the form and do it online. Login to myHRAVEBA online and click Systematic premium reimbursement.

Want to see your claims in progress and claims history? Login to myHRA VEBA online.