Forms

The following downloadable forms have been provided for your convenience. 

• Medical Claim Form
• GBP Supplemental Information (Primary Care Physician (PCP) Selection) Forms
• HIPAA Authorization Form to Disclose Protected Health Information (PHI)
• Transitional Benefits
• BlueCard Worldwide (for out of country claims)
• Prescription Drug Forms (If you need help with prescription drug claim forms, call Caremark at (888) 886-8490.)