Questions? 1-800-356-5221

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Questions? 1-800-356-5221

Chat with a 5-star expert now!

Kaiser Permanente

Fill Out Claim Form

Download it here . Complete the claim form above and submit it along with your itemized receipt and prescription to the address listed on the back of your Health Plan ID Card. The US Expediters, Inc. dba Federal Tax ID is 760521364.

Attach Receipt & Prescription

We'll include a receipt with your package, or you can download a copy from your account.

You can download a copy of your prescription from your account.

Submit Claim Form, Receipt and Prescription

Note: Receipts for masks with headgear and machines with humidifiers do not break down the cost separately because they are a packaged item. If your insurance provider has questions, please do not hesitate to reach out to us!

Get Money Back

After submitting your claim, you'll typically be reimbursed within 2-3 weeks. (Depending on your provider, it can be faster or slower.)

Not Your Provider?

If this page doesn't show your insurance provider, click the button below to return to a menu to select the right provider. Claim forms are often specific to each company. You don't want to fill out the wrong one!

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