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Advantage Plus Hospital Claim Form

If you have a GTL policy, click above and you can print off a Claim Form to get your benefits.

Fill it out all and any necessary documents pertaining to your claim(s), such as, a Hospital Stay, or the use of an Ambulance.

Short Term Home Health Rx Benefits Form

If you have a SHORT TERM HOME HEALTH policy and you want the money owed to you for your Prescription Drugs, complete the above form.

 

MDC Insurance Services

13 Park Ave W, Suite 305
Mansfield OH 44902

 419-566-3477

  [email protected]