NALC CDHP Forms — Easy Access, Simple Submission
Quickly find and complete the forms you need to manage your NALC Consumer Driven Health Plan (CDHP). Whether it’s filing a medical claim, managing prescriptions, or requesting privacy changes—we’ve got the tools to help.
All the essential forms you may need for your Consumer Driven Health Plan are here. Whether you're filing a claim, seeking reimbursement, or updating your coverage details—you'll find what you need.
Download and submit prescriptions, claims and Medicare- related forms. It's your one-stop hub for staying organized and covered.
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Caremark Forms
Use these forms for prescriptions fulfillment and reimbursement under your NALC Consumer Driven Health Benefit Plan.
Claim Forms
Submit claims for care you received while covered under the NALC Consumer Driven Health Plan.
Privacy Forms
Take control of who can access your health records through your NALC Postal CDHP.
Mail all completed forms to:
Privacy Officer – NALC Health Benefit Plan
20547 Waverly Court – Ashburn, VA 20149
SilverScript® Prescription Drug Program Forms
For Medicare-eligible CDHP members using the SilverScript® Prescription Drug Program (PDP).
We're Here
Your questions matter. Reach out for help with your NALC Postal Consumer Driven Health Plan forms or coverage.
NALC HBP Member Services
For general plan questions, our team is ready to assist you.
Download Your
Plan Brochure
For all the detailed information on your benefits—including exclusions and limitation —please download your official Plan Brochure.
Frequently Asked Questions (FAQs) — Quick Answers for You
Once you complete a form, check the instructions on that specific form. Most forms will have a mailing address printed directly on them, such as the Chattanooga, TN address for medical claims or the Ashburn, VA address for privacy requests. Always send your forms to the address listed, or follow the submission method provided—some forms allow fax or electronic submission.
If you paid out of pocket at a non-network pharmacy, or for short-term needs, complete the Short-Term Prescription Claim Form and include your detailed pharmacy receipt. If you have Medicare Part D, use the SilverScript Prescription Claim Form.
Yes. To give another person permission—such as a spouse, caregiver, or family member—submit the Authorized Representative Form under the HIPAA Privacy section. Once approved, that person will be able to speak with the Plan about your benefits, claims, and coverage on your behalf.
If you have upcoming travel, complete the Vacation Prescription Request Form. This form allows you to receive an early refill so you don’t miss doses while you’re away.