Trustmark Benefit Claim Form PDF Details

If you have ever needed to make a claim on your Trustmark insurance policy, you will know just how important the benefit claim form is. This document is used by Trustmark to determine whether or not you are eligible for the claim you are seeking to make, and it is essential that you complete it correctly and provide all the necessary information. In this blog post, we will take a look at what information is required on the Trustmark benefit claim form, and give some tips on how to complete it accurately.

Here are several facts you may want to analyze before you start dealing with the trustmark benefit claim form.

Form NameTrustmark Benefit Claim Form
Form Length4 pages
Fillable fields0
Avg. time to fill out1 min
Other namestrustmark wellness benefit claim form, trustmark claim form, trustmark claim form pdf, trustmark voluntary benefit solutions wellness claim form

Form Preview Example

How to Use Your Health Screening Benefit

How to Use the Health Screening Benefit of Your Critical Illness Policy

Did You Know?

If you have the health screening benefit, it reimburses you when you have any of the following standard screening tests performed. This is only a partial list.*

Plus, if you have family coverage, each family member is covered too! The benefit pays the actual cost incurred for a Health Screening Test taken by a covered person up to the benefit amount shown in the rider schedule.



Breast Ultrasound

Pap smear

Serum cholesterol

PSA test for prostate cancer

Stress test on bicycle or treadmill


Chest X-ray

Fasting blood glucose test

Your health is important. Trust us to help you protect it.

*Partial list. Covered tests may vary by state.

Frequently Asked Question!

Q. My Health Screening Benefit has a 60-day waiting period. After the waiting period, how do I submit a claim?

A. For a Health Screening Beneit claim, simply provide Trustmark with a copy of the bill, which contains your name, the name and address of the facility where the test/ procedure was performed, the specific test/ procedure, the date and cost of the test.

You can mail your vaccine or screening evidence to:

Trustmark Insurance Company

100 North Parkway

Suite 200

Worcester, MA 01605

Or fax it to: (508) 853-2867

During enrollment, a benefit counselor will be available to answer any additional questions you may have. If you have questions after you receive

your policy, call us at (800) 918-8877.

Health Screening Rider HS-12000/R is a part of Critical Illness Insurance Plan Form CACI-82001, underwritten by Trustmark Insurance Company, Lake Forest, Illinois. Please see your Rider and Rider Schedule for your state for exact terms, provisions, exclusions and limitations that apply.

Underwritten by Trustmark Insurance Company

Rated A- (EXCELLENT) A.M. Best

Rated A- (STRONG) Fitch

400 Field Drive Lake Forest, IL 60045

© 2010 Trustmark Insurance Company

P485-659 (R10-10)

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