Sonata, PlanDirect and Prelude
How to make a claim for you or your child
Use these forms to request reimbursement for expenses covered by your plan, including vision, dental and prescription drugs.
To submit a claim:
- Print the relevant form below and complete it. Some forms may require your doctor to fill out certain sections.
- Attach all of the required documentation, including receipts.
- Return this form to us at the address on the form.