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BCBSMRX1 Prescription Drug Claim Forms

Who is this for?

Michigan Health Insurance – Customer Service – Documents and Forms

If you're a Blue Cross Blue Shield of Michigan member with an Rx group of BCBSMRX1, use these forms if you've paid up front for prescription drugs that your insurance covers and you'd like to be reimbursed.

When you're getting a prescription filled, the pharmacy usually just bills us electronically.

However, sometimes you may have to pay up front for prescription drugs that your insurance covers. If the Rx group on your enrollee ID card is BCBSMRX1, you can ask us to pay you back for that expense. Choose the appropriate form below.

What you’ll need

  • Enrollee ID card
  • Pharmacy receipts
  • A copier or scanner to make copies of receipts for you to keep
  • A printer to print the form
  • An envelope and postage to mail the form

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

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