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Claims & Accounts Account Balances Medical Claim Summary Health Reimbursement Account Health Savings Account Flexible Spending Account(s) View Statements Other Claims Prescription Claims Dental Claims Vision Claims Mental Health Claims Member Actions   Submit a Claim Appeal a Claim Automatic Payment Options Mailing Preferences Direct Deposit Coordination of Benefits Request ID Cards Submit a Claim Medical Claim Form (PDF) Complete Sections A through E. Attach bills or receipts with a paperclip (do not staple) and mail to: PO Box 659752 San Antonio, TX 78265-9752 HRA Claim Form (PDF) Complete Sections A through E. Attach bills or receipts with a paperclip (do not staple) and mail to: PO Box 659752 San Antonio, TX 78265-9752 FSA Claim Form (PDF) -Insert instructions- and mail to: -insert address- -insert address- Vision Claim Form (PDF) -Insert instructions- and mail to: -insert address- -insert address- The member reimbursement form and instructions are in PDF format. You must have Adobe Acrobat Reader® to view these files.

Also See   View personal health record Look up medical benefits   Common Questions more   What do I do if I don’t agree with the way a claim was processed? How can I see my medical history?