Travel Medical Claim (insurer-specific) · Travel Insurance Companies
Claim for reimbursement of medical expenses incurred while traveling domestically or internationally. Requires documentation of the medical event, itemized bills, and proof of payment.
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File through the travel insurance company's claims portal
Mail to the travel insurer's claims department
Email claim documents to the insurer's claims email address
Filing Deadline
Typically 90 days from the date of the medical event. Some policies allow up to 1 year. Check your specific policy.
2-6 weeks after all required documents are received. Complex claims may take longer.
The insurer will review your claim and may request additional documentation or a medical review. Reimbursement is sent via check or direct deposit.
PA Request (insurer-specific) · Health Insurance Plans
Request for approval of surgical procedures, imaging studies, specialist referrals, or other services requiring pre-authorization. Must demonstrate medical necessity.
Pharmacy PA (insurer/PBM-specific) · Health Insurance Plans / PBMs
Request for coverage of formulary drugs requiring PA, non-formulary drugs, or override of step therapy, quantity limits, or other utilization management edits.
Step Therapy Exception · Health Insurance Plans / PBMs
Request to bypass step therapy requirement and proceed directly to a preferred or non-preferred drug. Must document why first-step drugs are not appropriate for the patient.
Tiering Exception · Part D Plans / Commercial Insurers
Request to obtain a non-preferred drug at the lower cost-sharing tier. Prescriber must provide a supporting statement documenting why the lower-tier alternatives are not appropriate.
Specialty PA (insurer-specific) · Health Insurance Plans / Specialty Pharmacies
Prior authorization request for high-cost specialty medications including biologics, gene therapies, and other complex drugs. Requires detailed clinical criteria documentation.
DME PA (insurer-specific) · Health Insurance Plans / Medicare MACs
Request for coverage of wheelchairs, CPAP machines, hospital beds, prosthetics, orthotics, and other durable medical equipment.
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