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How do I submit a claim?

Who is this for?

Michigan Health Insurance - Customer Service - How to submit a claim?

If you've gone to a doctor who's not in your network, and your plan covers out-of-network services, follow these instructions on submitting a claim for reimbursement.

We want to make it as easy as possible for you to submit your claims. All you have to do is:

1. Fill out the appropriate claims form. The form you need depends on your plan and the service you want to be reimbursed for. Forms can vary depending on the type of care you received. They can also be different if you get your health care covered through the federal or state government. Please visit our list of claims forms to find the one you need.

Tip: Your Blues ID card can help you when you're filling out forms. Keep it handy.

2. Attach the original copies of your receipts to the claims form. The receipts should include an itemized list of the services you want to be reimbursed for. We can’t accept cash register receipts, canceled checks or money order stubs. 

What do my receipts need to have on them?

To help us process your claim quickly, please be sure that your receipts and claims forms include: 

  • The enrollee's name
  • Your health insurance contract number
  • The patient's name
  • The date the service was performed
  • Your health care professional's name
  • Your health care professional's address
  • Your health care professional's tax identification number
  • A description of the service performed (HCPCS or procedure code)
  • The diagnosis
  • How much the service cost (itemize the charges if there's more than one service on a receipt)

We've provided some sample receipts to help you understand the information that should be included.

Tip: If you're handling the claims for your family, you'll need to fill out separate forms for each family member.

3. Mail the claim and receipts to the address on the form.

Tip: You may want to make copies of your receipts for your records in case you have an issue with your claim.

What if I'm outside the U.S.?

If you receive health care services while you're traveling outside of the United States, you'll pay the health care professional at the time of service and fill out an international claims form to be reimbursed by us later. Most plans only cover emergency services you receive when you're outside the U.S.

The form and more detailed instructions about this can be found at the Blue Cross Blue Shield Association's website in the section about the BlueCard® Worldwide program.

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