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Vision: How to file a claim

Claims should be filed promptly. Use a SAMBA "Vision Care Claim Form" to submit your claim (follow the instructions on the form). Claims should be filed within 90 days after obtaining the service, or as soon thereafter as reasonably possible. Failure to file on a timely basis may invalidate your claim. SAMBA will not pay benefits for claims submitted more than two years from the date the expense is incurred except where the member is legally incapable.

Claim forms may be obtained from the SAMBA website at www.SambaPlans.com or by calling the SAMBA Member Services Unit at (800) 638-6589 or (301) 984-1440.

Mail or fax the claims to:

        SAMBA
        11301 Old Georgetown Road
        Rockville, MD 20852-2800
        FAX (301) 984-5860


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