The easiest way to enroll in a Blue Cross Blue Shield of Michigan Medicare plan is to sign up online. But if you'd rather use an enrollment form, you can find one here.
You can enroll online for any of our Medicare plans.
Download and fill out this form if you'd like to enroll in a 2025 Medicare Plus Blue PPO Essential, Vitality, Signature or Assure plan.
Download and fill out this form to add dental and vision coverage to your 2025 Medicare Plus Blue PPO plan.
If you have another one of our Medicare Advantage plans and want to switch to a PPO plan for 2025, use this form.
Download and fill out this form if you'd like to enroll in a 2024 Medicare Plus Blue PPO Essential, Vitality, Signature or Assure plan.
Download and fill out this form to add dental and vision coverage to your 2024 Medicare Plus Blue PPO plan.
If you have another one of our Medicare Advantage plans and want to switch to a PPO plan for 2024, use this form.
Download and fill out this form if you'd like to enroll in 2025 BCN Advantage HMO ConnectedCare or Local.
Download and fill out this form to add dental, vision and hearing coverage to your 2025 HMO plan.
If you have another one of our Medicare Advantage plans and want to switch to an HMO plan for 2025, use this form.
Download and fill out this form if you'd like to enroll in 2024 BCN Advantage HMO ConnectedCare.
Download and fill out this form if you'd like to enroll in 2024 BCN Advantage Local HMO.
Download and fill out this form to add dental, vision and hearing coverage to your 2024 HMO plan.
If you have another one of our Medicare Advantage plans and want to switch to an HMO plan for 2024, use this form.
Download and fill out this form if you'd like to enroll in 2025 BCN Advantage HMO-POS Prime Value, Community Value, Elements, Classic or Prestige.
Download and fill out this form to add dental and vision coverage to your 2025 HMO-POS plan.
If you have another one of our Medicare Advantage plans and want to switch to an HMO-POS plan for 2025, use this form.
Download and fill out this form if you'd like to enroll in 2024 BCN Advantage HMO-POS Prime Value, Community Value, Elements, Classic or Prestige.
Download and fill out this form to add dental and vision coverage to your 2024 HMO-POS plan.
If you have another one of our Medicare Advantage plans and want to switch to an HMO-POS plan for 2024, use this form.
Download and fill out this form if you'd like to enroll in one of our 2025 Part D plans, Prescription Blue PDP Select or Premium.
If you have another one of our plans and want to switch to a PDP plan in 2025, use this form.
Download and fill out this form if you'd like to enroll in one of our 2024 Part D plans, Prescription Blue PDP Select or Premium.
If you have another one of our plans and want to switch to a PDP plan in 2024, use this form.
Download and fill out this form if you'd like to enroll in one of our 2024 Medicare supplement plans.
Download this document to get a detailed comparison of coverage for each of our 2024 Medicare supplement plans.
Download and fill out this form if you'd like to add dental, vision and hearing coverage to your Blue Cross Medicare Supplement plan.
If you're currently enrolled in the Dental Vision Hearing Package for a Medicare supplement plan and would like to cancel your coverage, fill out this form.
If you and someone you live with both have a Blue Cross Blue Shield of Michigan Medicare Supplement or Legacy Medigap plan, you might be eligible for a household discount. The discount saves you 10% on your monthly premium.
Important information about Medicare supplement plans
This is a solicitation of insurance. We may contact you about buying insurance. Blue Cross Medicare Supplement plans aren't connected with or endorsed by the U.S. government or the federal Medicare program.