Changing MyBlue Medigap℠ plan option

2013 plan information

You can change to another MyBlue Medigap plan option once a year on the anniversary of the effective date of your coverage. We offer four Medigap plan options to supplement your Original Medicare coverage. 

For coverage information about each plan option and associated premium amounts please see your MyBlue Medigap Brochure.

• MyBlue Medigap Brochure (PDF)

Changing to another MyBlue Medigap plan option is easy. Simply print and complete the MyBlue Medigap Plan Option Change Form.

• MyBlue Medigap Plan Option Change Form (PDF)

Complete, sign and return the MyBlue Medigap Plan Option Change Form to the following address:

BCBSM Individual Business Underwriting, MC: X513
600 Lafayette East
Detroit, MI 48226

Please note that your option change request is subject to medical underwriting approval. Once enrolled, your plan will take effect on the first day of the month of your one year anniversary of the effective date of your coverage.

If your option change request is rejected, you can simply continue coverage in the MyBlue Medigap plan in which you are currently enrolled.

Please call Customer Service at 1-800-662-6667 from 8 a.m. to 5:30 p.m. Monday through Friday for more information. TTY users should call 1-800-257-9980.

MyBlue Medigap offers access to any hospital, doctor or other health care provider in the U.S. or its territories that accepts Medicare assignment. The plan does not require members to use a specified provider network. MyBlue Medigap is a Medigap plan administered by Blue Care Network. Certain factors may affect the monthly premium cost: geographic location of the applicant’s residence, age, gender, height, weight and whether the applicant uses tobacco. Neither Blue Care Network nor agents authorized to sell Blue Care Network policies are connected with Medicare.