If you would like to submit a paper claim for reimbursement for a prescription that you paid for out of pocket, please print a copy of the Generic Reimbursement Claim Form located below.
After filling out the necessary information, please read the acknowledgement carefully (located at the bottom of page) and sign and date in the space provided.
To submit a Generic Reimbursement Claim Form, please be sure your receipts are complete. In order for your request to be processed, all receipts must contain the information listed below:
- Date prescription filled
- Name and address of pharmacy
- Doctor name or ID number
- NDC number (drug number)
- Name of drug and strength
- Quantity and days’ supply
- Prescription number (Rx number)
- DAW (Dispense As Written)
- Amount paid
This information can usually be found on the receipt which is stapled on the outside of the packaging or in some cases located inside. Your pharmacist can provide the necessary information as well.
Please mail completed form and receipt(s) to:
OptumRx Claims Department
P.O. Box 29044
Hot Springs, AR 71903
Welcome to the Customer Service Center! We are excited to assist you with any and all questions you may have regarding your policy.
On the left hand side we have provided you with a number of links and downloads for immediate access to any questions you may have regarding your school’s student insurance plan.
If you don’t see what you are looking for, or would like to speak to a live representative, it will be our pleasure to assist you.Â
Call Us
For questions regarding:
- Benefits
- Claims
- Change of address
- Requesting a new ID card
- My Account assistance
- General Policy Information
Please call 1-800-505-4160 to speak to a live customer service representative, toll free, 7 am – 7 pm CST.
Email Us
For questions and issues about the following:
- Waiver questions
- Enrollment questions
- Life Status Changes
Please Contact Us.
To send a written correspondence
Please send written correspondence to:
FIRSTSTUDENT
PO Box 809067
Dallas, TX 75380-9067
Welcome to the My Account center! My Account is a secure website that will provide you with personalized benefits and health information. Â
 With My Account, you’ll have 24/7 internet access to:
- Review Claims status, correspondence and Explanation of Benefits (EOB)
- Request/print an ID card
- Enter accident details online
- Enter additional insurance information online
Log into My Account: Existing My Account users log in here
Create your My Account: You will be able to create your My Account 24-48 hours after your initial purchase of coverage.Be sure to use the email address you used to purchase coverage.
Forgot Username/Password:If you have forgotten your username or password, we’re happy to remind you. Follow the link and enter the information requested. If a match is found, you will be emailed the information to the email address you provided when setting up your account.
My Account Mobile: UnitedHealthcare Student Resources and First Student are proud to announce you can now launch our My Account site from our mobile version! The new site puts students’ critical student insurance coverage information in the palm of their hands. On the run, no problem. You can now check the status of a claim, locate a provider or pharmacy nearby and even access your I.D. card at your convenience.The mobile site can be accessed on the iPhone 3 and 4, HTC, Samsung and Motorola Droid phones and the Blackberry v6.0. Supported browsers are Firefox, Chrome and Opera Mini. Of course, users of non-supported mobile devices and browsers can access the full My Account site at www.firststudent.com.
Welcome to the Customer Service Center! We are excited to assist you with any and all questions you may have regarding your policy.
On the left hand side we have provided you with a number of links and downloads for immediate access to any questions you may have regarding your school’s student insurance plan.
If you don’t see what you are looking for, or would like to speak to a live representative, it will be our pleasure to assist you.Â
Call Us
For questions regarding:
- Benefits
- Claims
- Change of address
- Requesting a new ID card
- My Account assistance
- General Policy Information
Please call 1-800-505-4160 to speak to a live customer service representative, toll free, 7 am – 7 pm CST.
Email Us
For questions and issues about the following:
- Waiver questions
- Enrollment questions
- Life Status Changes
Please Contact Us.
To send a written correspondence
Please send written correspondence to:
FIRSTSTUDENT
PO Box 809067
Dallas, TX 75380-9067
Welcome to the Review Brochures Center! You will find everything you will need to know about your policy in your plan brochure such as eligibility, effective and termination dates, plan benefits, any exclusions or limitations, and instructions on how to file a claim.
2015 – 2016 School Year   |   2014 – 2015 School Year
2015 – 2016 School Year
2014 – 2015 School Year
Welcome to the Review Brochures Center! You will find everything you will need to know about your policy in your plan brochure such as eligibility, effective and termination dates, plan benefits, any exclusions or limitations, and instructions on how to file a claim.
2015 – 2016 School Year   |   2014 – 2015 School Year
2015 – 2016 School Year
2014 – 2015 School Year
Welcome to the Review Brochures Center! You will find everything you will need to know about your policy in your plan brochure such as eligibility, effective and termination dates, plan benefits, any exclusions or limitations, and instructions on how to file a claim.
2015 – 2016 School Year
2015 – 2016 School Year
Welcome to the Review Brochures Center! You will find everything you will need to know about your policy in your plan brochure such as eligibility, effective and termination dates, plan benefits, any exclusions or limitations, and instructions on how to file a claim.
2015 – 2016 School Year   |   2014 – 2015 School Year
2015 – 2016 School Year
2014 – 2015 School Year