If you were under 18 when you used Teladoc, could not register because of that, and paid for the visit yourself, you can send us the receipt here and we will pass it to Point Comfort for reimbursement.

This form is only for visits where the registration problem left you paying for care you were covered for. For anything else, please use the Claims Center as usual.

ONE RECEIPT AT A TIME — if you have more than one, send this form again for each. That way each one can be paid as soon as it is approved, without waiting for the others.

This is on your insurance ID card.

In US dollars, as shown on your receipt.

One receipt per submission - PDF, JPG or PNG, up to 2MB. If you have more than one, send this form again for each.

Optional.

We use these details only to process your reimbursement. We do not keep a copy of your receipt beyond passing it on for review.

24-Hour Assistance:

Toll-Free (833) 483-0001
Direct +1 (317) 210 2010

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