Co-Pay Reimbursement

Co-Pay Reimbursement for Retired Members of The Detectives' Endowment Association

To receive a reimbursement of up $75 for the previous calendar year for your doctor visit co-pays, please complete the attached form.

You must attach your EOB statements from Emblem Health showing payment of copay and type of visit. (Doctor Office Receipts will not be accepted)

This form is only accessible January 1- March 31 for submission of previous calendar year visits.

To receive a reimbursement of up $75 for the previous calendar year for your doctor visit co-pays, please complete the attached form.

You must attach your EOB statements from Emblem Health showing payment of copay and type of visit. (Doctor Office Receipts will not be accepted)

This form is only accessible January 1- March 31 for submission of previous calendar year visits.