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Member Reward Forms

Who is this for?

Find forms here.

If you're a BCN AdvantageSM member and want to participate in Blue Advantage RewardsSM, you can find the forms here.

Do you want to get rewarded for staying on top of your health? Use the forms below to participate in Blue Advantage Rewards.

You can learn more about Blue Advantage Rewards in our Help Center.

For each form you complete and send to us, we'll send you different Entertainment® coupon book.

Blue Advantage Reward forms

You or your doctor can mail or fax the completed forms to the address below.

Blue Advantage Rewards
Mail Code G803
P.O. Box 68753
Grand Rapids, MI 49516-8753


  Fax to 1-866-637-4972

To get your coupon book, complete your exams by Dec. 31, 2014. Fax or mail the forms to us by Jan. 12, 2015.

Not all members are eligible for all rewards. Copays and deductibles might apply to these exams.

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Page Last Updated Tue Jun 24 16:02:43 EDT 2014