HealthPartners member claims

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How to file a claim with us

A claim is a request for us to pay for covered benefits under your plan. You or your provider must file a claim before we can reimburse costs according to your plan’s coverage.

There are different types of HealthPartners claims, depending on the plans or products you have, including:

  • Medical and dental claims
  • Pharmacy claims
  • Consumer-directed health plan (CDHP) claims, like Flexible Spending Accounts (FSAs) and Health Reimbursement Accounts (HRAs)
Many claims are submitted automatically on your behalf, but claims you submit yourself generally take us about four to six weeks to process. Please note:
  • If your primary insurance isn’t with HealthPartners, you’ll need to provide an Explanation of Benefits (EOB) from your primary insurance company when submitting a claim to us as a secondary payer.
  • If you have a Medical Assistance (Medicaid) plan with us, we’re unable to process claims you submit yourself.

If you have a question about how to file a claim with us, we’re here to help. Call Member Services at the number on the back of your member ID card or send us a message.

These are claims related to medical care, services or products covered under your HealthPartners medical insurance plan.

In-network providers are required to submit claims on your behalf. If your provider is in network, check to make sure they have your current insurance information on file. If you need further assistance, call Member Services at the number on the back of your member ID card or send us a message.

If you used an out-of-network provider for covered care, services or products, ask if they’ll submit a claim to us on your behalf. If they won’t, you can send us an itemized statement or detailed receipt (and supporting documentation) to get reimbursed for amounts you owe out of pocket that are covered by your plan. You may need to work with your provider to get the necessary information to file your claim.

These are claims related to dental care, services or products covered under your HealthPartners dental insurance or Medicare plan.

In-network providers are required to submit claims on your behalf. If your provider is in network, check to make sure they have your current insurance information on file. If you need further assistance, call Member Services at the number on the back of your member ID card or send us a message.

If you used an out-of-network provider for covered care, services or products, ask if they’ll submit a claim to us on your behalf. If they won’t, the out-of-network claim process depends on whether you have:

  • A dental insurance plan with us; OR
  • A Medicare plan with us that covers dental services
Out-of-network dental claims if you have a dental insurance plan

Send us an itemized statement or detailed receipt (and supporting documentation) to get reimbursed for amounts you owe out of pocket that are covered by your plan. You may need to work with your provider to get the necessary information to file your claim.

We don’t have a standard out-of-network dental claim form, but your submission must include:

  • Member name and ID number (written on each page)
  • Date(s) of service
  • Care provider name
  • Care provider address
  • Care provider tax ID number
  • Care provider phone number
  • ADA codes and descriptions, including tooth numbers or quadrants where applicable
  • Amount billed
  • Proof of payment (if you already paid your provider)

Please note that some services may require additional documentation. We’ll follow up with you if we need more details.

Please mail the above information to:
HealthPartners Dental Claims – 25510F
P.O. Box 1172
Minneapolis, MN 55440-1172

If you’ve already paid your provider, we’ll reimburse you for covered amounts. If you haven’t yet paid your provider, we’ll reimburse your provider for covered amounts.

Out-of-network dental claims for covered services under a Medicare plan

Fill out and send us the out-of-network Medicare dental reimbursement form (PDF) to get reimbursed for amounts you owe out of pocket that are covered by your plan. We must receive your request within 12 months of the date you received your dental service(s).

Be sure to include all information and documentation that’s asked for, including dated receipts, itemized bills, and dental codes and service descriptions for each service you’re requesting reimbursement for. You may need to work with your provider to get the necessary information to file your claim.

If you’ve already paid your provider, we’ll reimburse you for covered amounts. If you haven’t yet paid your provider, we’ll reimburse your provider for covered amounts.

These are claims related to prescription medicines covered under your HealthPartners medical insurance or HealthPartners prescription drug plan. (Please note that some employers use insurers besides HealthPartners to cover prescription medicines. If this applies to you, you’ll have a separate ID card from a separate company for your pharmacy benefits, and you’ll need to contact that company regarding how to submit a claim.)

Generally, your HealthPartners insurance will be checked when you fill your prescription at the pharmacy counter or receive a prescription in a medical facility. This creates an automatic claim, and the price you pay out of pocket factors in your insurance benefits.

If your insurance wasn’t checked when you filled your prescription and you paid full price out of pocket for a prescription, you can send us a claim and supporting documentation to get reimbursed under your coverage. You may need to work with your pharmacy or provider to get the necessary information to file your claim.

These are claims related to an FSA administered through HealthPartners.

If you have a HealthPartners insurance plan in addition to a HealthPartners-administered FSA, you’ll automatically receive a reimbursement equal to what you owe your provider out of pocket (after your insurance benefits are factored in). You can opt out of automatic claims submissions (PDF).

You can also submit a manual claim to get reimbursed from your FSA if you didn’t use your HealthPartners insurance (or if you don’t have HealthPartners insurance). Your claim must be for eligible medical expenses, and documentation is required.

You must have sufficient funds in your FSA for any claim, automatic or manual, to process in full.

These are claims related to an HRA administered through HealthPartners.

If you have a HealthPartners insurance plan in addition to a HealthPartners-administered HRA, you or your provider will receive a reimbursement equal to what you owe your provider out of pocket (after your insurance benefits are factored in). You can opt out of automatic claims submissions (PDF).

You can also submit a manual claim to get reimbursed from your HRA if you didn’t use your HealthPartners insurance (or if you don’t have HealthPartners insurance). Your claim must be for eligible medical expenses, and documentation is required.

You must have sufficient funds in your HRA for any claim, automatic or manual, to process in full.

Additional resources

If you have additional questions about claims, call Member Services at the number on the back of your member ID card or send us a message. We’re ready to help.

As part of our coverage criteria policies, some care, services or medicine may require prior authorization before they’re covered. For more information and details, contact Member Services.

Review your plan details

The easiest way to see your insurance plan details is to sign in to your HealthPartners account. If you have questions about your coverage, contact Member Services.

Are you a provider?

Find more information about submitting claims at our provider portal.