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Change of Status Form Spanish Language
Who is this for?
If you're a Blue Cross Blue Shield of Michigan or Blue Care Network member, use this form to let us know of any changes to your status, like address changes, name changes or adding people to your policy. This version of the form is written in Spanish.
Access the form here: Change of status form Spanish language (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.
If you have any questions, please contact us.
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