If you pay out-of-pocket for something that is an eligible HRA expense and was not part of the claims integration process, CDPHP provides you convenient ways to submit claims.

Submit Your HRA Claim Online

  • Log into the secure member site

  • Under Online Forms, click HRA Claim Form

  • Complete the form and upload your receipts

Submit Your HRA Claim by Mail

  • Download and print the HRA Claim Form

  • Complete the form. All fields are required.

  • Attach copies of your receipts and/or copies of supporting documentation indicating:

    • Name of person receiving service or product and the relationship to member

    • Name of provider

    • Date of service or date product was purchased

    • Description of service or product

    • Amount you paid for service or product

  • Mail to: CDPHP Health Funding, P.O. Box 6130, Albany, NY 12206-3960.

HRA claim forms can also be requested by calling 1 (877) 793-3960. Remember that you may not request payment for a medical service prior to that service being rendered.