Plan year: August 18, 2006 - August 17, 2007

Student Gold Health Insurance Plan

How do I file a claim?

In the event of injury or sickness:

1. Report to Wardenburg Health Center for treatment or referral.
2. If more than 50 miles away, go to your physician or local hospital.
3. Mail to the address below all medical and hospital bills, along with the patient's name and insured student's name, address, student ID number, and name of the university under which the student is insured. A company claim form is not required for filing a claim.
4. File the claim within 30 days of the injury or first treatment for a sickness. Bills should be received by the company within 90 days of service. Bills submitted after one year will not be considered for payment except in the absence of legal capacity.
5. You may also bring your bill to Wardenburg Health Center, room 251

Submit all medical claims or inquiries to:
AmeriBen
P.O. Box 7186
Boise, Idaho 83707
1-800-626-5520
https://services.ameriben.com
Group #: 0004005

Submit all prescription claims with a claim form to:
Express Scripts
P.O. Box 66773
St. Louis, MO  63166-6673
1-800-206-4005
www.expressscripts.com
Group #:  AM2E

Prescription claim forms are available in room 251 at the Student Health Plan Office.