Claims should be submitted via the AFSPA Member Portal for the quickest processing. To submit a claim using the Member Portal, you should complete a claim form with your first claim submission for each family member, and at least once per year per covered member, so that we have current address and other insurance information. Use the fillable PDF here. The completed form must be saved (or scanned) and then uploaded to the Member Portal with a PDF of your claim.
If you can’t scan the claim form to upload it to our Member Portal, please mail it and your claim to us at Foreign Service Benefit Plan, 1620 L Street, NW, Suite 800, Washington, DC 20036-5629.
For massage therapy claims, please make sure the therapist’s license or certification number (and Tax ID number if available, for providers in the U.S.) are on the bill; and if you paid for these services, please provide a receipt.
If your doctor is in our network, generally, your doctor will send the bill to us. If we need more information, we’ll contact your doctor or you directly.
If your doctor isn’t in our network and he or she will not bill us, ask them for an itemized bill with the information referenced in Section 7 of the FSBP Brochure, filing a claim for covered services.
You don’t need to fill out a claim form for each claim you submit. We do, however, ask you to complete one claim form each year for every covered member of your family. This will ensure that we have your current address and other insurance information.
Your payroll/HR office does not advise us of address changes. You also can update your address in the Member Portal.
Be sure to provide us with the member name, address, and dependent name if applicable; include a description of the sickness or accident and physician’s name and address (if not included on the bill).
When filing a claim for services rendered by an overseas provider, bills and receipts should be itemized and show:
If you have received care from a provider with whom we have a Direct Billing Arrangement, you should not have paid for anything except for any deductible or coinsurance you might owe. The provider will bill us directly and we pay the provider for covered services.
All of the information for your claim can be submitted via the Member Portal. And, you will receive reimbursement faster if you submit your claim in the Member Portal and also use Electronic Funds Transfer (EFT) for your claim reimbursement. The registration form for EFT can also be found in Aetna Navigator.
*You can still access you claims for December 31, 2017, and earlier at My Online Services (MOS). You may want to download your claims and EOBs before the site is taken down at the end of 2018.