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.
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:
P.O. Box 30192
Salt Lake City, UT 84130-0192
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 view your plan specific member materials.
Member Rights and Responsibilities
picture_as_pdf Member Rights & Responsibilities
picture_as_pdf Member Rights & Responsibilities (CHIP)
picture_as_pdf Member Rights & Responsibilities (CHIP - Español)
picture_as_pdf Member Rights & Responsibilities (Medicaid)
picture_as_pdf Member Rights & Responsibilities (Medicaid - Español)
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.