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HPI Acquires MedCost

We are excited to share that MedCost has been acquired by Health Plans, Inc. (HPI), a national leader in self-funded health plan solutions. Read the full press release.

MedCost
Downloadable Forms

Frequently Used Employer Forms

Claims forms are here for your members. If you have questions, please call our Customer Service Contact Center at 1-800-795-1023.

Medical and Dental Claims Forms

If you received care or a bill from an out-of-network provider, use these forms to submit a claim for reimbursement or to request coverage.

Authorization to Release Information

Members can use the following forms to give MedCost permission to share information about themselves (or a dependent) with another person or organization.

Spending Account Reimbursement (FSA)

Reimbursement forms related to your flexible spending account (FSA).

Weekly Disability Income Claim

Members use this form for short-term disability claims.

These forms as well as additonal forms for enrollment are located within your secure account.