Get University Of California Berkeley Prescription Drug Reimbursement Form
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How to fill out the University of California Berkeley Prescription Drug Reimbursement Form online
Filling out the University of California Berkeley Prescription Drug Reimbursement Form is essential for students seeking reimbursement for prescriptions obtained outside the Tang Center. This guide provides step-by-step instructions to assist users in completing the form accurately and efficiently.
Follow the steps to complete the form effectively
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering your name in the designated field to clearly identify your submission.
- Input your student ID number into the appropriate field, ensuring accuracy for proper identification.
- Fill in your Anthem Blue Cross Member ID number, which consists of the letter 'XDP' followed by an underscore and your unique identifier.
- Indicate your group number, which is '275670' and must be included for processing.
- Select the plan type by circling one of the options: M001 for graduate students, M002 for undergraduate students, or M003 for Filing Fee/Withdrawal/Concurrent Enrollment students.
- Provide your date of birth in the specified format (mm/dd/yyyy) to ensure proper record-keeping.
- Select your gender by marking the appropriate option, which is indicated as either ( ) M for male or ( ) F for female.
- After completing all required fields, make sure to review the form for any errors or omissions before proceeding.
- Save your changes, download a copy of the form, and print it for your records.
- To submit your reimbursement request, include your prescription receipts and the medication label, then choose one of the submission methods: drop off at the Student Health Insurance Office, fax, scan and email, or mail it to the provided address.
Complete your documents online today for a smooth reimbursement process.
Shipsurance provides coverage for shipping-related damages or losses, assisting you in recovering costs if something goes wrong during shipment. This type of insurance is beneficial for businesses and individuals looking to safeguard their deliveries. Remember, however, that while managing your healthcare needs at Berkeley, utilizing health resources like the University of California Berkeley Prescription Drug Reimbursement Form can ensure you secure necessary funds for prescription expenses effectively.
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