Claims
Claims, claims, claims! It’s the topic we are asked about the most. We put together this page to help answer all your questions. If you still have a question, you know what to do! (Contact us of course!)
When to submit a claim
If you paid out-of-pocket for a covered expense, submit a claim to be reimbursed. Read step-by-step instructions here or read more below.
How to Submit a claim
Submit your claim on eBenefits or the mobile app for the easiest experience. You can also download a Claim form and submit it (but we really encourage you to use the website!).
What to submit with your claim
- Follow the steps on eBenefits or the mobile app to guide you through the submission process.
- Complete your information (name, employer, etc) and patient information (if the claim was for a dependent on your plan)
- Share your diagnosis or complaint (i.e., what was the visit for?)
- Complete reimbursement details so we know how to pay you back
- Take a picture of your itemized receipt (not just your credit card copy) that shows individual dates of service, description, and cost of the services – and upload it with your submission
Claim Tips
Try to use direct pay
The best way to avoid submitting a claim is to use a direct pay provider who will bill MetLife instead of you for the cost of your services. Learn more about direct pay providers on our Network page.
Include all necessary attachments
Include your itemized bills and payment receipts. An itemized bill should clearly identify individual dates of service.
Multiple dates of service
For each date of service, ensure a description of the service and the cost per service are available.
Good lighting please!
Please make sure your images are clear so we can read them – that means bright lighting, center the invoice in the middle of the image, and make sure the numbers are legible.
Don’t wait too long
You have a limited time to submit claims — check your certificate, found on eBenefits, for details. Claims submitted after this deadline may be denied.
What happens next?
After you submit your claim, here is what you can expect for next steps:
We process your claim. Our goal is 10 business days.
You receive an email that your claim was processed. Check eBenefits to see your Explanation of Benefits.
Any reimbursement owed will be issued according to your preferences. Please note, international banking can delay receipt.
Once your claim is processed
You will receive an email once your claim has been processed. Check eBenefits to find the details of how your claim was processed (please note that we cannot send claims details in emails due to privacy concerns). Processed claims will appear on the eBenefits home page under the “Processed Claims” section.
Your claim number can be identified by looking at the date of service and billed amount.
If reimbursement is owed to you, it will be issued to the bank account on file. Please note that it will take additional time for funds to appear in your account, particularly if international banking is involved.
If you have a question about your claim, please contact Customer Service. You can reference your confirmation email you received when submitting your claim, including the reference number, so that we can find your claim quickly.