Anthem gym reimbursement form 2026

1. Click ‘Get Form’ to open the anthem gym reimbursement form in the editor.
2. Begin by filling in all unshaded sections of the form. Start with your name, date of birth, and identification number as shown on your ID card.
3. Provide your subscriber's information, including address and telephone number. Ensure that all details are accurate to avoid delays.
4. Record the workout period by entering the start and end dates of your exercise sessions. This is crucial for verifying eligibility.
5. Attach your original receipts and completed Fitness Reimbursement Program Log Card or fitness center printout to the back of the form.
6. Sign the form yourself and have a fitness center employee sign it as well. Don’t forget to date the form upon completion.
7. Finally, send your completed form along with all attachments to the Claims Department at Anthem Blue Cross and Blue Shield.

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