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Claims guide – Insurance premium expenses
Claims guide – Insurance premium expenses
- Health insurance premiums
- View a complete list of covered expenses
Not covered:
- Dental, vision, or life insurance premiums.
Paying for premiums
Your grant can cover health insurance premium expenses from:
- The current month
- In your look back period (6 months prior to award date)
- Up to two months in advance
- (You can be reimbursed if you have already paid in advance and submit proof of payment.)
- Paying your insurance company directly
- Reimbursing you for premiums already paid
- Payments to you are sent in the form of check by mail, or by EFT if you have signed up for EFT.
Electronic Funds Transfer (EFT)
If you want to have reimbursements directly deposited into your checking account, sign up for Electronic Funds Transfer (EFT) with TotalAssist.
How to submit a claim
Claim form – when submitting a paper form by fax or mail
- Your specific claim form contains a barcode that identifies you in our system. A paper copy is included in your welcome packet in the mail. Please make copies of your barcoded blank claim form so you have some ready to use.
- Remember to sign your claim form before submitting.
Claims in your portal account
- You can complete and submit a claim in your portal account. There is no paper form for this method of submitting a claim.
- Gather required supporting documents for the claim. All documentation must include your name. Handwritten supporting documentation is not accepted.
- View list of required supporting documents
- Submit your claim in your portal account with supporting documentation attached, anytime 24/7.
– or – - Submit your claim by fax or mail. Your claim should include your completed and signed barcoded, patient-specific claim form, plus copies of your supporting documentation. Submit to:
- Fax to: 757-952-0119
- Mail to: TotalAssist, 421 Butler Farm Rd, Hampton, VA 23666
Required supporting documents
If you have a Medicare Supplement and/or Medicare Part D plan that you pay for directly (not out of your Social Security check)
- Premium amount
- Your name
- Insurance company name and logo
- Receipts
- Bank or credit card statements
- Cancelled checks
If you have a Medicare premiums that come directly out of your Social Security check
- Must show the amount deducted from your Social Security check
If you have health insurance through your employer or COBRA
- Receipts
- Bank or credit card statements
- Cancelled checks
- Paystubs showing each deduction. If your paystub includes a year-to-date amount, submit a copy of your most recent paystub.
If you have health insurance not through an employer (Marketplace, private insurance, etc.)
- Receipts
- Bank or credit card statements
- Cancelled checks
- Paystubs showing each deduction. If your paystub includes a year-to-date amount, submit a copy of your most recent paystub.
Please make sure all required documents, and your signed, completed claim form, are submitted with your claim. Your claim could be delayed or denied if required documents are missing, if your signature is missing, or if you did not use your patient-specific claim form.
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