Claim Forms are available on this page as well as in your post enrollment materials; each of the attached forms contains instructions on how to complete.

Your medical provider may prefer to file a claim for you using his or her own form. However, if you have a claim, you must send in a signed claim form for the corresponding service, this will help ensure prompt processing of your claim. Please consult your post enrollment materials or contact SRC’s Member Service Department for additional details.

• Medical Benefits
• Dental Benefits
• STD Disability Request
• Vision Benefits

Send completed forms to:
SRC, an Aetna Company
Attn: Claims Department
PO Box 23759
Columbia, SC 29224-3759