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  • Oxford Gym Reimbursement Form

Get Oxford Gym Reimbursement Form

Gym Reimbursement Form Mailing Adress: P.O. Box 7082, Bridgeport, CT. 06601-7082; Phone: 1-800-444-6222 Important: Please complete this form in its entirety, or the processing of your claim may be.

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How to fill out the Oxford Gym Reimbursement Form online

The Oxford Gym Reimbursement Form is designed to simplify the process of requesting reimbursement for gym memberships. This guide will provide clear instructions for users to effectively complete the form online, ensuring a smooth submission and prompt processing of your claim.

Follow the steps to successfully complete the form online.

  1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editing tool.
  2. Begin by entering your name in the designated field. Ensure that you provide your full name as it appears on your gym membership.
  3. Input your Oxford Member ID Number. This number is essential for identifying your account and processing your reimbursement claim.
  4. Fill in your mailing address. Provide your complete address to ensure that any correspondence or reimbursements are directed correctly.
  5. Record the dates of your gym visits in the 'Date of visit' sections. You need to document a total of 50 visits within a six-month period, so ensure each date is clearly noted in the respective fields.
  6. Identify the name of the facility where you have completed your visits. Accuracy in this section will help avoid confusion during the reimbursement process.
  7. Obtain a facility employee's signature in the relevant section. This signature confirms that the facility promotes cardiovascular wellness, which is a requirement for reimbursement.
  8. Affix your signature at the bottom of the form to affirm that all information provided is accurate and complete. This step is crucial for the validity of your claim.
  9. After filling out the form, review all entries for accuracy. Make sure each section is complete to prevent delays in processing your claim.
  10. Once you have verified your information, save the changes to the form. You may choose to download, print, or share the completed document as needed for submission.

Complete your Oxford Gym Reimbursement Form online today to receive your reimbursement efficiently.

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Oxford Products from UnitedHealthcare. At UnitedHealthcare, we offer a wide range of affordable and flexible health plans for most businesses. We have three quality Oxford networks, Freedom, Liberty and Metro, to enable greater flexibility in pricing.

Have gone to the gym and/or exercise classes 50 times in six months. Your reimbursement period begins on the date of your first fitness facility visit or class and ends six months later, after you have completed 50 visits, 50 classes, or a mix of visits and classes that add up to 50.

On April 26, 2004, Oxford Health Plans, Inc. and UnitedHealthcare, a wholly-owned subsidiary of UnitedHealth Group, announced an agreement to merge.

While other health plans have come and gone, Oxford has provided reliable access to care and coverage along with an unwavering dedication to our customers throughout New York, New Jersey and Connecticut since 1984.

Oxford Health Insurance started in 1984 specializing in group health insurance coverage. Through its extensive network, they offer a wide range of affordable health plan options.

If you have questions related to OBM, you can contact us via e-mail at obm@ancillary-benefits.com, or contact Member Services at 1-800-521-9845.

Reimbursement is generally limited to the lesser of $200 (subscriber/plan participant)/$100 (covered spouse/partner/eligible dependent ages 13 and older) or the actual amount of the qualifying fitness costs per 6-month period, but the reimbursement may vary by plan.

Oxford Health Plans is a part of the UnitedHealthcare Company. Medical plans can generally be purchased in 3 states: Connecticut, New Jersey, and New York. Coverage is available to individuals, families, and employers. There is a choice of Point of Service (POS) plans, which include the Freedom Plan and Liberty PlanSM.

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