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Blue Access for Members Video Tour
As a Blue Cross and Blue Shield member, you get Blue Access for Members, a website where key features of your plan are just a click or a tap away. Find highlights quickly, along with your payment history and costs for seeing a doctor. If your plan offers pharmacy, dental, or vision benefits, you'll find those details here too. You can even print copies of your ID card.
Use the cost estimator tool for budgeting. This helps you plan for tests and treatments, and get a handle on the cost of care. Checking the status of claims is easy. They're here in one place. We've added a search function and more filtering tools to help you find the information you need. You can create claim groups to organize claims the way you want them.
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Find Medicare Advantage Plan, Medicare Advantage Dual Care Plan (HMO SNP), Prescription Drug Plan and Medicare Supplement Insurance Plan forms and documents you need to help you manage your Medicare plan.
Blue Cross Medicare AdvantageSM Plans Documents
Blue Cross MedicareRx (PDP)SM Plan Documents
Blue Medicare Supplement InsuranceSM Plan Documents
Blue Cross Medicare Advantage Dual Care (HMO SNP)SM Plan Documents
2019 Personal Medication List
2019 Online Coverage Determination Request Form
2019 Online Coverage Redetermination Request Form
2019 Mail-Order Physician New Prescription Fax Form
2019 Pharmacy Mail-Order Form
2019 Prescription Drug Claim Form
2019 Medicare Part B vs. Part D Form
2019 Authorization to Disclose Protected Health Information (PHI) Form
2019 CMS Appointment of Representative Form
2019 Notice of Privacy Practices
2019 Access Additional Privacy Forms
2019 Automated Premium Payment (ACH) Form (PDP)
2019 Automated Premium Payment (ACH) Form (MAPD)
2019 Automated Premium Payment (ACH) Form (DSNP)
2019 Prescription Drug Coverage Determination Request Form (PDP)
2019 Prescription Drug Coverage Redetermination Request Form (PDP)
2019 Prescription Drug Coverage Determination Request Form (MAPD)
2019 Prescription Drug Coverage Redetermination Request Form (MAPD)
2019 Prescription Drug Coverage Determination Request Form (DSNP)
2019 Prescription Drug Coverage Redetermination Request Form (DSNP)
2019 Prescription Drug Formulary Exception Physician Form
2019 Prescription Drug Tier Exception Physician Form
If you would like to submit feedback directly to Medicare, please use the Medicare Complaint Form or contact the Office of the Medicare Ombudsman.
Last Updated: 11302018Y0096_WEB_TX_MM19a Accepted