Download it here. Call the Customer Service number on the back of your Health Plan ID Card and ask for the mailing address for claim forms. Complete the claim form above and submit it along with your CPAP.com itemized receipt and prescription to the mailing address identified by your insurance company. MedCall Healthcare Advisors, LLC Tax ID is 47-3681247. You can download more specific instructions (start on page 7) for filling out the claim form here.
After submitting your claim, you'll typically be reimbursed within 2-3 weeks. (Depending on your provider, it can be faster or slower.)