Mail Order Drug Forms

If you have any questions, call the number on the back of your enrollee ID card, or please contact us.

Blue Cross Blue Shield of Michigan

Use the form that matches your Rx group number to order and get prescription drugs by mail. 

• Rx group number BCBSMAN mail order form
• Rx group number BCBSMRX1 mail order form
  

Blue Care Network

• Medco prescription drug mail order form
  

Medicare member?

You can find mail order drug forms on our Medicare website.

Specialty drugs

Blue Cross Blue Shield of Michigan and Blue Care Network members can use this form to order and get your specialty drugs by mail.

• Walgreens specialty pharmacy enrollment form
  

Related Items

• Drug lists
• Will the Medco® name change affect how I refill my prescriptions?
• How can I find a pharmacy to fill my prescription?
• How to save money on prescription drugs