Online Forms
Click on the name of the form you need in order to download the form or print out a copy directly from your PC.
 
Kemper Senior Solutions Insurance Claim Form 
Should be filled out completely and submitted with the physician and/or hospital bill. See the Notice to Residents on page 2 of the claim form.

 
Bank Draft Authorization Form 
If you would like to have your premiums drafted from your bank account or you currently have this option and you need to change your banking information, complete the top portion of this form and submit it with a voided check from the account from which you want us to draft. Another easy way to pay your premium is with your credit card. Complete the bottom portion of this form and submit it.

 
Health Care Provider Claim Inquiry 
To investigate the way Kemper Senior Solutions Company has processed a particular claim, please complete this form and submit it per the instructions on the form.

 
Home Health Certification Claim Form
Physician's Home Health Care Certification claim form, see the Notice to Residents on page 2 of the claim form. Please complete this form and Mail it to:

      Kemper Senior Solutions

      PO Box 9965

      Austin, Texas 78766-9965   


If you are resident in Texas, please download the state specific form by clicking on your state name.
About Us


Resources & Support


Get in Touch Today
Toll Free: 877.877.0199
Fax: 405.254.2120

Mailing Address:
Kemper Senior Solutions
PO Box 9965
Austin, Texas 78766-9965

In California, Reserve National Insurance Company does business as Kemper National Life Insurance Company
Copyright by KemperSeniorSolutions.com            HIPAA Privacy Notice