Here's the individual and family form: Blue Care Network Primary Care Physician Selection form - Individual or family (PDF)

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 on where to send it.

Step by step instructions:

  1. Select your primary care physician. If you need help finding one, use to find a list of doctors that participate in Blue Care Network.
  2. Complete the form, sign and return it to us as soon as you enroll so that we can notify your doctor of your membership.

Fax or mail the form to:

Membership and Billing – M.C. H300
Blue Care Network
P.O. Box 5043
Southfield, MI 48086
Fax: 1-877-218-1466

If you have any questions, please contact us.