Claims Status and Forms
Get paid back for covered expenses.
When you pay for a covered medical expense yourself, filing a claim tells your plan to pay you back. Usually, your doctor’s office handles this for you. But sometimes you need to file a claim yourself or check on one that’s in progress.
You can file online or download a claim form. Check the back of your plan ID card to see which resources apply to you.
Aetna (includes Banner Local Plan)
- Aetna website
- Aetna medical claim form (PDF)
- Questions or help: 855-548-2387
BlueAdvantage Administrators of Arkansas
- BlueAdvantage website
- BlueAdvantage medical claim form (PDF)
- Questions or help: 866-823-3790
UMR (Mercy Local Plan)
- UMR Website
- Claim form medical plans - UMR (PDF)
- Questions or help: 800-804-1272
UMR
- UMR website
- Questions or help: 855-870-9177
Pharmacy
Dental
- Dental claim form (PDF)
- Delta Dental: 800-462-5410
Additional Forms
Call People Services at 
See the 2025 Associate Benefits Book for more information about your benefits and eligibility. It will control over any conflicting information on this page.
