Submit a Claim

Submitting a claim is simple.

Submit a Claim

By mail.
1. Click here to download a claim form.
The claim form is in Adobe® PDF format. If you do not have Adobe® Acrobat Reader®, which will enable you to view and print the claim form, click here to download a free copy.
2. Complete the form and be sure to sign it.
3. Mail your completed, signed form, along with a copy of the receipt for the dental services you are claiming, to:

Denex Dental Claims
P.O. Box 10949
Rockville, MD 20849

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