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Member Service Request Form Instructions At UnitedHealthcare, we continuously strive to bring you a higher level of service. Although you are not required to submit this form, completing it will help us …

Use this Request for Reimbursement form to ask for payment from your FSA for eligible care you’ve already received.

For Medical, Dental, Vision and Hearing Expenses, submit your insurance carrier’s explanation of benefits (EOB) statement with your completed form. When applicable your insurance claim must be …