How to make and check claims

In this guide

Making a claim is simple using your online account. From the app or Online Member Services, you can submit a new claim, track its progress and review your claim history and payments.

How to make a claim
Viewing claims in your online account

How to make a claim

Depending on the service and providers, you can claim in person, from your online account or by completing a claim form.

In person

If your provider has a HICAPS terminal, tap your digital membership card, or ask them to swipe your membership card. If your claim’s approved, you’ll only pay the difference between what you get from us and the total cost on the spot.

Make a claim using your online account

Before you start

• Do you have the right receipt? Here's what information needs to show in your receipt
• Is your claim within 2 years?
• Have you already claimed through Medicare?

For hospital claims, some services require you to claim through Medicare first. Learn about hospital claims

Steps

In either Online Member Services or the My Teachers Health app:

1. Select Make a claim
2. Start my claim
3. Choose the person the claim is for
4. Select the category that describes your claim
5. Upload up to 3 receipt(s) or documents that are images (JPG, JPEG, PNG) or PDFs. They must be less than 5.0 MB in size
6. Review the details of your claim, then Agree & submit

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Viewing claims in your online account

Check your claims history and status in the My Teachers Health app

1. Select Claims in the bottom navigation 
2. If you have more than one member on your cover, you can select them at the top of the screen 
3. Switch between In Progress and Processed to see claims that are still being assessed and claims that have been processed 
4. Select any claim to view full claim details, including benefits paid (if applicable) 

Check your claims history and status in Online Member Services

You can access your claims history in two ways:

Option 1: from the Home screen

1. Go to the Your claims section on the right side of the Home screen
2. Select the relevant member (if more than one applies)
3. A listing of all claims for the member will appear below
4. Select a claim to expand it and view the full details

Option 2: from the Claims menu

1. Select Claims from the navigation menu
2. From the Filters, select the member you want to view claims for
3. Select or deselect any Claim status options
4. Apply filters
5. A listing of claims for the member will display on the Claims history screen
6. Select a claim to view its details

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