1. Download the Below Reimbursement Form.
2. We Give You an Itemized Receipt and a Copy of the United Out-of-Network Reimbursement Form for You to Sign and Complete.
3. Mail the Completed Form and Your Itemized Receipt to:
Download the form below and follow the instructions carefully.Make sure to include your Honest Eyecare™ itemized receipt when you mail your completed form.Honest Eyecare™ does not represent and is not affiliated with Aetna®.
Click the link below and follow the instructions carefully. Make sure to include your Honest Eyecare™ itemized receipt when you submit your completed form.