Never search for a medical claims form again!

Submitting your out-of-network medical claims can be a real pain. It should be as easy as logging into your insurer’s website and clicking a button. But unfortunately, insurers tend to bury their medical claims forms in hard-to-reach places. They do this because insurance companies don’t want you to use your out-of-network benefits. We’ll discuss that in more detail below. But first, let’s talk about who uses claims forms, and when. Then we’ll provide links to medical claims forms for top U.S. insurers to make your search easier!

When Should I Use an Out-of-Network Insurance Claim Form?

When you see an out-of-network (OON) provider, you generally pay for the services out of pocket. To get some of that payment reimbursed, you have to file a claim. (For in-network services, your healthcare provider files the claim on your behalf.)

To be eligible for reimbursement, your health insurance plan needs to have OON benefits. If you have a PPO or POS plan, you probably have OON benefits. These benefits also need to cover the service you received. Finally, you need to have already paid your medical bill. If all those things apply to you, you can file an OON claim.

For that, you’ll need a claim form. Each insurer has their own specific claim form. So normally, to file a claim, you need to locate the claim form buried in your insurer’s website. Now however, you can go straight there from the links at the bottom of this blog post. 

Why are Out-of-Network Claims so Difficult?

In our post, How to Check Your Out-of-Network Benefits, we explained why insurers make it hard for you to check your OON benefits. The short answer is, they want to show you the few great, cost-effective benefits they’re offering you, while hiding the not-so-great stuff. This means it’s tough to check your coverage for services that don’t make the front page, like OON services.

Insurers aren’t exactly incentivized to help you use your OON benefits. If you see an OON specialist and don’t file a claim, that leaves more money in your insurer’s pocket. So, just like checking your OON benefits, using your OON benefits, i.e. filing claims, is often (unnecessarily) difficult. You have to locate specific claims forms buried in your insurer’s website, then fill them out and submit them (usually by snail mail!) yourself. Even though your doctor’s office already recorded this information.

Finding Out-of-Network Medical Claims Forms

SuperBill’s mission is to save patients time and money that they’re losing to insurance. We make OON reimbursement easier for patients. This is why we’ve combed the web for links to claims forms for the top insurers in the US. To use this alphabetized list, scroll down to your insurer’s name or use [Ctrl+F / ⌘+F] to search for it. 

According to the 2020 Census, about 67% of US health insurance is managed by private companies. And, the five largest companies combine for a whopping 40% of the market share. This list is not meant to comment on the quality of any of the insurers listed. Rather, we chose the biggest insurers in order to help the greatest number of patients. We’d love for it to grow. If your insurer isn’t on this list, let us know at support@thesuperbill.com and we’ll do our best to add it.  

Finally, while this blog post can take you directly to your medical claims forms, it sadly cannot file those claims for you. Do you want the help of insurance experts to check your benefits and file your claims? If so, check out SuperBill’s website.  Click the Get Started button, and a team of insurance claims experts will start turning your OON medical bills into reimbursements today. You won’t have to lift a finger!

Without further ado, here are the top U.S. health insurance companies’ claim forms for your OON claims:

Aetna Medical Claims Forms

Aetna’s claims forms page also includes tax forms, accident forms, and spending account reimbursement forms. 

Aetna Health Insurance Claim Form

Alliant Health Medical Claims Forms

There are a lot of documents on Alliant’s claims forms page, so try to single out the one you’re looking for. The basic claim form is the third line in the left-hand column, “Member Medical claim form.” 

Alliant Health Insurance Claim Form

Allied Benefit Systems Medical Claims Forms

The third heading in the left-hand column, “Medical, Dental, and Vision Claim Forms,” has everything you need to file Allied Benefit claims. 

Allied Benefit Systems Health Insurance Claim Form

Blue Cross Blue Shield Medical Claims Forms

Blue Cross Blue Shield (BCBS) is a little trickier than the rest. Because BCBS is so big and plans vary from state to state, you will probably have to sign in to access claims forms specific to your plan. But, you can use the following link to sign in and/or see a partial list of BCBS claims forms.

Cigna Medical Claims Forms

To access Cigna’s claims forms from the following link, click the dropdown labeled Medical Forms, or sign in to access plan-specific claims forms. 

Cigna Health Insurance Claim Form

Delta Claims Forms

Delta’s claims forms are arranged in a pretty neat 3 x 3 grid. But note that if you’re appealing a Delta claim denial, you need to click the Other Forms button to access the appeal form. 

Delta Health Insurance Claim Forms

Empire Blue Cross Blue Shield Claims Forms

Empire Blue’s claims forms page is pretty cluttered. From the following link, select Claims under the dropdown labeled View By Topic to make your life easier.

Empire Blue Health Insurance Claim Forms

GEHA Medical Claims Forms

GEHA still requires you to send OON claims by mail… 😏Also note that in many states, their claims are actually handled by United Healthcare (at the bottom of this list). Scroll to the bottom of GEHA’s claims page to see if you’re in one of those states. 

GEHA Health Insurance Claim Form 

Humana Medical Claims Forms

Humana’s claims forms page starts you under the Medicare tab. If you have another type of Humana plan, use the buttons at the top to select it. 

Humana Health Insurance Claim Form

Kaiser Permanente Medical Claims Forms

We couldn’t find a page with a comprehensive list of Kaiser Permanente claims forms. Kaiser requires you to sign in and go to My Coverage and Costs to submit a claim online. (Note: make sure you’ve selected your state and region from the dropdown at the top left of the page.) 

Alternatively, we did find a Kaiser Permanente claim form pdf to submit a claim manually, regardless of your state and region. 

Tricare Medical Claims Forms

Amazingly, Tricare’s site has a handy set of instructions for filing claims! 👀

Tricare Health Insurance Claim Form

United Healthcare Medical Claims Forms

The claims forms page for United Healthcare (UHC) has a wide range of financial, tax, and legal forms. But the medical claims form is conveniently located at the top of the list. 😎

UHC Health Insurance Claim Form

Tell Us What’s Missing

Feel free to contact SuperBill if you’d like us to add your health insurer’s claims forms page to this list.