What type of documentation should I include with my eligible medical expense reimbursements?
You can substantiate your claim with one of the following:
- The Explanation of Benefits (EOB) statement returned to you from the insurance carrier indicating the amount you are responsible for
- Copay receipts if you are covered under a managed care or prescription drug plan
- If there is no insurance for the health care expenses, submit an itemized bill with the following:
- Name of the provider and patient
- Service cost, date, and description
- Notation when there is no coverage
What type of documentation should I include with my premium reimbursement?*
You can substantiate your claim with a Premium Notice, such as a bill or acceptance letter from the insurance company, which includes the following:
- The premium amount
- The effective date of coverage
- Name of the person insured – this will be you, your spouse or a qualifying dependent
Good Documentation vs. Bad
Good documentation includes:
- A breakdown of each service and/or medical expense
- The date each service and/or medical expense was incurred
- Your name (or your spouse / eligible dependent’s name, if the expense is for them)
- We suggest an EOB, Itemized Statement, or Copay Receipts because these forms of documentation will always include the information we need to quickly process your reimbursement.
- See left for an example of an Itemized Receipt.
Bad documentation examples:
- A late notice that only includes the total amount owed and does not include a description of the services incurred
- A credit card receipt that only includes the total amount paid
- See left for an example of bad documentation.
If you have questions on reimbursement documentation, please email us at claims@myMidAmerica.com.
*Flexible Spending Accounts do not reimburse premiums. This applies to Health Reimbursement Arrangements.