Health Care Reimbursement Account Claim Form
Please use this form to request reimbursement for: eligible expenses not covered by any insurance plan, or the unpaid balance of a health, dental, or vision care claim submitted under an employees group plan.
Questions about a claim? Please contact WageWorks at 877-924-3967.
| Form Name | Format |
|---|---|
| Health Care Reimbursement Account Claim Form (can be filled in electronically) |
* Some Duke HR forms may require you to list your Duke Unique ID. If you do not know or are unsure of your Duke Unique ID, you can look it up here.
** Some forms available on this web site are in Adobe Portable Document Format (PDF). You will need Adobe Acrobat Reader to view and print these forms.
** Some forms available on this web site are in Adobe Portable Document Format (PDF). You will need Adobe Acrobat Reader to view and print these forms.