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If this is your first time signing into your medical claim reimbursement portal, please kindly contact the SDFRA team, as you’ll need to have an activation link sent to your email. Please either call (619) 281-0354 (option 2) or email mail@sdfra.org.
| Reimb. | Member Only | Billing Code | ||
| $400 | $15.00 | Medical Visit | MCOP | Includes reimbursemnet for all other medical visits not specifically outlined below and includes hospital (inpatient-per-day), lab, radiology (cardio-scans), chiropractic, acupuncture, massage, home health, ambulance, dialysis, to mention a few. |
| *out of $1,000 Annual Member Family- Medical Reimbursement | $10.00 | Pharmacy | MRXR | -RX drug co-pays, up to $10 per 30 day supply |
| $100.00 | Deductible | MDED | Your medical deductible up to $100/year |
| *Reimb. | Flex Fund Eligible Elements | Billing Code | ||
| $300 | $300.00 | Dental | FDEN | Dental and vision procedures and hardware up to $300 per family and may be used for your Qualified Dependents. |
| *out of $1,000 Annual Member Family- Medical Reimbursement | $300.00 | Vision | FVIS | Dental and vision procedures and hardware up to $300 per family and may be used for your Qualified Dependents. |
| $50.00 | Home and Auto Ins Ded (per year) | FAHI | Per Family per year. | |
| $50.00 | Fitness Club Membership (per year) | FAHI | Per Family per year. |
| Reimb. | Dependent Eligible Benefits | Billing Code | Dependent reimbursement (Reimb subject to $300 of the $1000 family annual max) | |
| $300 | $15.00 | Medical Visit | DCOP | Includes reimbursement for all other medical visits not specifically outlined below and includes hospital, lab, radiology (cardio-scans), chiroporactic, acupuncture, massage, home health, ambulance, dialysis, to mention a few. |
| *out of $1,000 Annual Member Family- Medical Reimbursement | $10.00 | Pharmacy | DRXR | -RX drug co-pays, up to $10/ per 30 day supply. |
IMPORTANT: Do not submit the medical claim reimbursement form when submitting your claims through the portal. Do not submit this form online. Please download, print, and mail your completed form to:
San Diego Fire Relief Association
10509 San Diego Mission Rd. Ste. F
San Diego, CA 92108
IMPORTANT: Do not submit this form online. Please download, print, and mail your completed form to:
San Diego Fire Relief Association
10509 San Diego Mission Rd. Ste. F
San Diego, CA 92108
IMPORTANT: Do not submit this form online. Please download, print, and mail your completed form to:
San Diego Fire Relief Association
10509 San Diego Mission Rd. Ste. F
San Diego, CA 92108
* Please note that in order for us to process your receipts, we ask that this reimbursement claim benefit form be filled out completely. This will help our claims team get you your reimbursements in a timely manner. Do not submit this form online. Please download, print, and mail your completed form to:
San Diego Fire Relief Association
10509 San Diego Mission Rd. Ste. F
San Diego, CA 92108
We’d love to hear from you. Send us a message with any questions you have and we’ll get back to you shortly!