Usually, we pay your health care providers for you without you having to do anything. But, sometimes you have to pay the doctor or hospital yourself. This form is how you ask us to reimburse you.
You can use the Member Application for Payment Consideration form to ask us for reimbursement for dental claims you have paid for yourself.
You can use the Accidental Dental Member Application for Payment Consideration form to ask us for reimbursement for accidental dental claims you have paid for yourself. Accidental dental injury is defined as an external force to the lower half of the face or jaw that damages or breaks the teeth, periodontal structures or bone. Damage to the mouth by self-inflicted external force or chewing isn’t covered.
Use this form to ask for reimbursement for medical expenses related to metabolic diseases and foods.
If you have a problem with your Blue Cross Blue Shield of Michigan service, you can use this form to file an appeal with us.
Some employers can object to contraceptive coverage, but the Affordable Care Act says you can ask us to make an exception for you. Use this form to request contraceptive accommodation.
If you have to pay a provider or hospital for services, this form is how you ask us to reimburse you.
This form is for bills you receive from providers who don't participate with us. Use it to send us a bill that you haven’t paid.
Use these forms if you've paid up front for prescription drugs that your insurance covers and you'd like to be reimbursed.
Fill out this form if you need to be reimbursed for payments to an out-of-network Blue Vision provider.
Fill out this form if you need to be reimbursed for payments to an out-of-network Essential Vision provider.
Blue Cross Blue Shield of Michigan answers common questions about claims, like how to submit or check the status of a claim, and more. Read about it here.
Use this form to enroll a subscriber in a new plan or make changes to an existing plan, such as adding or removing a dependent.
Use this if you have a Blue Cross Blue Shield of Michigan plan that requires a qualification form.
If you're a Blue Care Network member, use this form to select or change your doctor.
Blue Cross Blue Shield of Michigan provides information about updating your coverage, requesting your personal records, and paying your bill. Learn more.
This application may be used for 2024 individual and family coverage through either Blue Cross Blue Shield of Michigan or Blue Care Network.
This application may be used for 2025 individual and family coverage through either Blue Cross Blue Shield of Michigan (BCBSM) or Blue Care Network of Michigan (BCN), depending on which medical plan you choose. Dental plans, dental with vision, and adult vision plans are only offered through BCBSM, but can be paired with BCBSM or BCN medical plans.
A summary of benefits and coverage from Blue Cross Blue Shield of Michigan or Blue Care Network explains things like what your health plan covers, what it doesn't cover, and what your share of costs will be.
Shopping for health insurance does not have to be difficult. Blue Cross Blue Shield of Michigan explains what to know to make the right choice. Learn more.
Use the Optum prescription drug mail order form to get your prescription drugs by mail.
Specialty drugs are prescription medications that require special handling, administration or monitoring.
Is your medication covered by your Blue Cross Blue Shield of Michigan health plan? Click on the helpful drug list links to find out.
Do you want more information about your prescription drug plan? Blue Cross Blue Shield of Michigan explains everything you need to know. Learn more here.
Learn more about the Blue Elect Plus POS and Blue Elect Plus HSA POS health plans.
As a Blue Care Network member with BlueCard® coverage, you can receive benefits when you’re away from home, and so can your dependents.
When you’re a Blue Elect Plus POS or Blue Elect Plus HSA POS member, you’re always covered for emergency care while traveling.
This tells providers that you’re covered by Blue Elect Plus POS and how they can get information about your coverage.
Learn how a health reimbursement arrangement works with your health plan.
Learn how Healthy Blue Living helps you take charge of improving your health.
If your body mass index is 30 or higher, enroll in one of these programs.
Keep this with your Blue Care Network member ID card, and show it to your doctors and other health care providers when you get care.
Learn how we coordinate health coverage with your car or motorcycle insurer.
This tells providers that you’re covered by Blue Elect Plus POS and how they can get information about your coverage.
As your health care partner, your PCP makes sure you get the care you need when you need it
How referrals work for Blue Care Network members in Mid-, West and Northern Michigan
Learn how Healthy Blue Living helps you take charge of improving your health.
Here’s what you need to know about emergency care.
Follow these guidelines for physical, occupational and speech therapy, as well as physical medicine services.
Learn more about the Blue Care Network policy for getting equipment or supplies.
For routine women’s health services, you may visit certain Blue Care Network specialists without a referral from your primary care provider.
In Good Health, you'll find plan-related information as well as tips, recipes and articles that can improve your health and well-being.