Here are forms you may need related to your health care coverage through the UAW Retiree Medical Benefit Trust. If you can't find a form or have a question, call the Customer Service number on the back of your enrollee ID card and we'll help.
Would you like a representative to talk to your group about their health care coverage?
These forms are for managing protected health information. That's what Blue Cross Blue Shield of Michigan calls your private medical information we have on file.
What you’ll need:
- Your enrollee ID card
- A printer to print the form
- An envelope and postage to mail the form, or a fax machine. Each form includes instructions, a mailing address and a fax number.