Claims Status and Forms
Get paid back for covered expenses.
When you pay for a covered medical expense yourself, filing a claim tells your plan to pay you back. Usually, your doctor’s office handles this for you. But sometimes you need to file a claim yourself or check on one that’s in progress.
You can file online or download a claim form. Check the back of your plan ID card to see which resources apply to you.
Aetna (includes Banner Local Plan)
- Aetna website
- Aetna medical claim form (PDF)
- Questions or help: 855-548-2387
BlueAdvantage of Arkansas
- BlueAdvantage website
- BlueAdvantage medical claim form (PDF)
- Questions or help: 866-823-3790
UMR (Mercy Local Plan)
- UMR Website
- Questions or help: 800-804-1272
UMR
- UMR website
- Questions or help: 855-870-9177
Pharmacy
Dental
- Dental claim form (PDF)
- Delta Dental: 800-462-5410
Additional Forms
See the 2024 Associate Benefits Book for more information about your benefits and eligibility. It will control over any conflicting information on this page.