Need Help?

We're here to answer your questions.

Enrollment Forms

Who is this for?

Medicare Help Center | Forms | Enrollment Forms

The easiest way to enroll in a plan is to sign up online. But if you'd rather use an enrollment form, you can find one here.

Signing up for a Medicare plan online is easy and efficient. You just have to find your plan and click the green "Enroll" button.

But if you'd rather fill out a paper form and send it in to us, you can find one here. Here's what you'll need to do:

  • Choose your plan type below
  • Choose the plan you want to enroll in
  • Download the form and print it out

We'll let you know if you need anything to fill out your form and make sure you have basic instructions before you start.

Looking for MyBlueSM Medigap enrollment forms? 

You'll find them here:

Was this content helpful?

Rate it

Submit >

©1996-2014 Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association. State and Federal Privacy laws prohibit unauthorized access to Member's private information. Individuals attempting unauthorized access will be prosecuted.

Site Map  |  Feedback  |  Important Legal and Privacy Information  |  Important Information About Medicare Plans

Y0074_W_Oct14WebBCBSBCN Pending CMS Approval

Page Last Updated Thu Jul 10 14:16:28 EDT 2014