Below are documents and descriptions to support you on your medical journey. Please return these forms to the information listed on the form.
If you disagree with the outcome of a medical claim, you have the right to submit an appeal.
If you have or are currently receiving care related to an injury or accident with third-party liability such as an automobile accident, please fill out this form to enable our team to process your claims faster.
If you have a qualified dependent over the age of 26 that you believe needs to be covered on your plan, please fill out this form.
If your care is currently under care/treatment of a provider who is out-of-network on your JUDI Health plan, but was in-network on your previous plan, please fill out this form.
If you or your dependents are currently enrolled in another medical plan in addition to your employer-sponsored plan (e.g. Medicare, Tricare, spouse’s employer sponsored plan) please fill out this form to enable our team to process your claims faster.
If you need to know which procedures require pre-certification for coverage or what types of procedures and events are explicitly excluded under your medical plan, please refer to this document.
Documentation of the process for members to submit out-of-pocket medical expenses for reimbursement.