Medical Expense Reimbursement

You may receive medical expense reimbursement for your out-of-pocket expenses related to your accepted condition(s) that were incurred prior to the acceptance of your claim under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Reimbursement of expenses is allowed retroactive to the filing date of your claim.

To be considered for payment, bills must be submitted by the end of the calendar year after the year when the expense was incurred, or by the end of the calendar year after the year when the claim was first accepted as compensable by the Division of Energy Employees Occupational Illness Compensation (DEEOIC).

As an Example: Your claim is accepted on January 2, 2016. The filing date of your claim is January 1,2015.
Reasonable and customary medical treatment and prescription bills that were incurred between January 1, 2015 and January 1, 2016 for the accepted condition(s) are reimbursable. Your request for medical expense reimbursement must be submitted no later than December 31, 2017 on Form OWCP-915.

File for Medical Expense Reimbursement

To obtain reimbursement for out-of-pocket medical expenses for covered medical care, complete the Form OWCP-915, Claim for Medical Reimbursement. In addition, you must submit the following items which are to be attached securely to the claim form:

• Provider’s itemized billing statement
• Receipt of payment by your provider
• Evidence of your method of payment

Acceptable evidence of payment includes a cash receipt, copy of your cancelled check (both front and back), or a copy of your credit card receipt. Up to eight visits or services can be listed on one form if the service was provided by the same medical provider. Each entry must be filled in completely. Receipts may be attached in lieu of listing each item. Mark the item “see attached.” A separate form must be completed for different medical providers.

Mail the completed Claim for Medical Reimbursement form with attachments to the medical bill payment agent at:

Energy Employees Occupational Illness Compensation Program
P.O. Box 8304
London, KY 40742-8304

Medical Benefits with a EEOICPA Medical Benefits ID Card

Medical benefits for your accepted condition(s) include reasonable and customary medical care, drugs prescribed by a physician, and travel directly associated with the treatment of an accepted condition. You do not pay a deductible or a co-payment. Payment to your medical provider by the DEEOIC is considered payment in full. An established list of maximum dollar allowances for services is utilized in the payment of medical bills.

The following is a list of just some of the services that may be covered for treatment of your accepted condition(s):

• Doctor’s Office visits
• Medical treatments
• Consultations
• In-patient and out-patient hospital charges
• Emergency room visits
• Diagnostic laboratory and radiological testing
• Durable Medical Equipment
• Drugs prescribed by a physician, both branded and generic
• Ambulance services
• Travel to the doctor, hospital, clinic, pharmacy, and other medical facilities

Costs NOT Covered Under the EEOICPA

The following are some of the most common costs that are NOT covered under the EEOICPA:

• Treatment of medical conditions not related to your accepted condition(s)
• Medical treatment for anyone other than yourself
• Medicines that are not prescribed by a doctor
• Prescriptions for non-accepted conditions under the EEOICPA
• Personal services in the hospital such as telephone or television

EEOICPA Liaison Services

As one of our clients you do not need to go it alone in obtaining benefits under the EEOICPA. Loyal Service Agency Inc. not only provides you the best in-home health care services but we also provide you our expertise and knowledge of the EEOICPA.

We specialize in assisting our clients and patients navigate the bureaucracy of the EEOICPA. Loyal Service Agency’s EEOICPA Liaison can assist you in making additional claims, obtaining ancillary medical benefits, filing for reimbursement of out of pocket expenses, and many other available benefits under the EEOICPA.

Isn’t time for you to have someone dedicated to assisting you with your claims and benefits under the EEOICPA? Get your questions answered and join our family today by calling 1-855-485-6925.