How do I submit a claim for a payment I made at the doctor, pharmacy or dentist?

Who is this for?

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

Blue Cross Blue Shield of Michigan, Blue Care Network and Blue Dental℠ members under age 65.

When you go to the doctor or dentist who takes your insurance, you usually don’t have to do much at checkout. That’s because the office and your plan handle the paperwork:

  • The provider sends us a claim for their services
  • We figure out what your plan covers and how much
  • We send the provider payment for charges your plan covers
  • You get a bill later from the provider for amounts your plan doesn’t cover

But some providers don’t submit claims to us. They may collect payment from you in full at the time the service or prescription is provided. This can happen when you:

  • Go to a doctor, dentist, pharmacy or other provider who doesn’t take your insurance
  • Need care while traveling outside of the U.S.

In these cases, you’ll have to send us the claim yourself. 

How to submit a claim

You’ll need to fill out a claim form and mail or fax it to us. Then we can figure out what your plan covers and how much. We’ll reimburse you for charges your plan should pay.

  • Medical and dental services and prescriptions you got in the U.S., Puerto Rico or the U.S. Virgin Islands: Use these claim forms
  • Medical care you got anywhere else, including on a cruise ship outside U.S. waters: Use the Blue Cross Blue Shield Global Core international claim forms. You’ll need your Blue Cross ID card to log in to the site
  • Prescriptions you got outside the U.S., Puerto Rico and the U.S. Virgin Islands: Use these claim forms

How long you have to submit a claim

These deadlines apply to members submitting their own claims.

  • For medical claims, all plans:
    Deadline to submit is two years from the date of service
  • For pharmacy claims, all plans:
    Deadline to submit is one year from date of service or as required by your plan
  • For Blue Dental℠ claims:
    Deadline to submit is two years from the date of service