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Healthcare Spending Account (HCSA) claim forms

Have coverage through your employer or plan sponsor? You’re in the right place.

If you have coverage through an advisor, use our personal insurance forms instead.

Submit your claim online

Your online account makes it easy to submit your claims online or print forms that are pre-filled with your personal information.

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Start a paper claim

Use these forms to make a healthcare spending account (HCSA) claim. You'll find instructions for submitting each form on the form itself.

Not what you’re looking for? Find the forms you need.

I have coverage through my employer

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I bought coverage through an advisor

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