Medical expenses
How to make a claim for you or your child
Use this form to request reimbursement for medical expenses covered by your plan.
To submit a claim:
- Print the form below and complete it.
- Attach the relevant bills and receipts. We won’t be returning these, so please retain copies for your tax purposes.
- When the form is completed, please return it to the address on the form.
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Use this form to claim expenses relating to medical or vision treatment and prescription drugs. You'll need itemized receipts for some sections.
Not forms you're looking for? Go back to the find a form page.