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If You Saw an Out-of-Network Provider and Paid Out-of-Pocket
Out-of-network providers may require payment at the point of service. In these circumstances, you should submit a Medical Claim Form to your health care company (see "How to Submit a Claim") to be reimbursed for the Plan's share of the expense. Be sure not to sign the box on the Medical Claim Form or check the box when submitting the claim online on aetna.com or mycigna.com that authorizes your health care company to make payment directly to your provider, as the payment should be made to you.
Your health care company will process your claim to determine your and the Plan's responsibility.
  • If you elected automatic claim payment, in addition to processing the claim to determine the amount the Plan should have paid, your health care company will determine what amount can be paid directly to you by available MRA funds first, and then from your HCSA, if applicable.
  • If you elected or were defaulted to the debit card, you will receive an EOB showing the amount paid by the Plan. You can then submit an MRA and/or HCSA Claim Form to request reimbursement if you paid with your personal funds (see "How to Submit a Claim").