

MEMBERS
Planning on going to a provider that's not in our network?
Simply fill out the VIPA
and send it in with your receipt!
*This form should only be used if
going to a provider that is NOT on our network.
If you are going to a participating
provider, that provider will submit a claim for you.
Would you like to see something different on this web-site?
Have any suggestions?
Let us know!!