Critical Illness Wellness

1. Complete a Wellness Claim Form and mail or fax the completed form and a copy of the itemized bill indicating patient name, date of service, name of provider, type of service, and diagnosis code to Reserve National Insurance Company at the address or fax number indicated below.  Paper claim forms submitted can take up to 10 business days for processing.

Reserve National Insurance Company
P.O. Box 9988
Austin, TX 78766-9988
Fax:  844-473-8084

2. See a Midwest Heritage Representative during a store visit.  For assistance in filing a claim or to inquire about your store’s next Midwest Heritage Representative store visit, please call 800-622-0057 or 515-343-5047 or email csr@mhbankins.com.

According to the plan guidelines, a wellness benefit will be paid only one-time per year for each covered family member. Listed below are the common wellness screenings that can be considered for a wellness claim. (Full-time employees on Hy-Vee’s core medical plan can submit their biometric screening, which includes a lipid panel.)

Abdominal aortic aneurysm ultrasound
Blood test for triglycerides     
Bone marrow testing       
Breast ultrasound         
CA 15-3 (blood test for breast cancer)
CA 125 (blood test for ovarian cancer)
Carotid ultrasound         
CEA (blood test for colon cancer)
Chest x-ray       
Colonoscopy     
CT Angiography     
EKG        
Double contrast barium enema  
Fasting blood glucose test 
Flexible sigmoidoscopy 
Hemoccult stool analysis 
Mammography 
Pap Smear    
PSA (blood test for prostate cancer)        
Serum cholesterol HDL/LDL      
Serum protein electrophoresis (blood test for myeloma)
Stress Test 
Thermography 

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  Critical Illness Claim

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  Critical Illness Wellness