How Do I File a Claim with My CitizenSecure® Economy Plan?
Filing a claim for your CitizenSecure® Economy policy is easy. Once your Application is accepted, you will receive a kit that contains a Claimant’s Statement and Authorization form. Complete this Claimant’s Statement and Authorization form, attach original, itemized bills, and forward them to HCCMIS. Be sure to complete your Claimant’s Statement entirely and sign it. If you have already paid certain expenses, attach copies of your payment receipts. You will be reimbursed for eligible medical or dental expenses. In many cases, HCCMIS will make payments directly to the hospital or physician that treated you. Remember, you are responsible for the deductible, coinsurance, and any ineligible charges. Download an electronic copy of the Claimant’s Statement and Authorization form now.
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