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You can submit claim via My Account, mail or fax. Review details in Claim Center.

Below information provides details of what is needed to submit a medical or prescription claim.

File a medical claim

To file your medical claim for consideration, please provide the following information. All submitted documents must be legible.

• • A copy of your medical ID card as well as the patient information, if different than the primary insured.
  • Medical claims – must be an itemized bill listing each service provided, diagnosis, the service date, and the cost per service. The provider’s name, tax ID number, address and phone number should also be included. Grouped services are not considered an itemized bill. Claims missing any of the requirements listed above will be denied for reimbursement until the required information is submitted.
  • Proof of payment – if payment was made by check, please provide a copy of the front and back of the cancelled check. For all credit card payments, the credit card statement showing the cardholder’s full name, institution name and payment information for each date of service is required. If payment was made with an ATM or Debit card, the bank statement showing the accountholder’s full name, institution name and payment information of each date of service is required. We will call the provider of services to verify all cash payments.
  • Be sure to include your current mailing address.

File a prescription claim

To file your prescription, claim for consideration, please provide the following information. All submitted documents must be legible.

• • A copy of your medical ID card as well as the patient information, if different than the primary insured.
  • A copy of the prescription label showing the patient name, prescribing doctors name, drug name, date dispensed, quantity and purchase price for each prescription
  • Proof of payment – if payment was made by check, please provide a copy of the front and back of the cancelled check. For all credit card payments, the credit card statement showing the cardholder’s full name, institution name and payment information for each date of service is required. If payment was made with an ATM or Debit card, the bank statement showing the account holder’s full name, institution name and payment information of each date of service is required. We will call the provider of services to verify all cash payments.
  • Be sure to include your current mailing address.

Note: If the claim is for Optum Rx, please visit the Optum Rx Web Portal to submit your prescription claims.