Claims

If you want to submit a claim to SelectHealth, rather than the provider submitting the claim for you, you may fill-out a Claim Reimbursement Form. Follow the instructions on page 2. Generally claims must be submitted within one year from the date of service, though longer time limits do exist in certain circumstances.

If your policy is canceled, any claims submitted during the grace period or before the plan was canceled (when the member was not eligible) will be denied. Some exceptions apply for those with an advanced premium tax credit. Some exceptions apply for those with an Advanced Premium Tax Credit (APTC). You can prevent this by always paying your full premium. Learn more about retroactive denials.

 

How to File an Appeal

If you disagree with our decision on your claim, you or your authorized representative can submit an Appeal Form to:

Attn: Appeals
SelectHealth
P.O. Box 30192
Salt Lake City, UT 84130-0192

 

Exclusions

Certain services may not be covered under your health insurance plan. While each plan may differ, refer to the list of exclusions in our sample plan documents

Already a member? Log in to My Health to view your plan specific member materials. 

 

Recoupment of Overpayments

If you pay too much (overpay) toward your premium and your policy is still active, we will apply this overpayment to the next month’s premium. If your policy has been terminated, the overpayment will be refunded—unless benefits were used after the termination date, in which case, the refund will be offset by the benefits used and we will refund any remaining amount. If you have questions, call 844-442-4106, option 3.

 

Member Rights and Responsibilities

You are entitled to important rights as a member of our health insurance plan. Know your Member Rights and Responsibilities:   

      Member Rights & Responsibilities

      Member Rights & Responsibilities (CHIP)

      Member Rights & Responsibilities (CHIP - Español)

      Member Rights & Responsibilities (Medicaid)

      Member Rights & Responsibilities (Medicaid - Español)

 

Privacy Practices

Your privacy is important to us. We understand the importance and sensitivity of your personal information. View our Notice of Privacy Practices to learn more.