Jump to Content
Managing Your Claims
Subscriber submitted claims:
Submit the appropriate form, with original itemized receipts, to request reimbursement for paid services received within the U.S.
Medical, Vision or Hearing Services Claim Forms
- Federal Employee Programs (FEP) Member
Medical, Vision or Hearing Services (PDF) - Lansing Regional, Michigan House of Representatives, or Michigan Senate Member
Medical, Vision or Hearing Services (PDF) - Medicare Advantage Member
Medical, Vision or Hearing Services (PDF) - Michigan State University Member
Medical, Vision or Hearing Services (PDF) - State of Michigan (SOM) Member
Medical, Vision or Hearing Services (PDF) - All Other Members
Medical, Vision or Hearing Services (PDF)
Dental, Prescription Drug and Medicare D Prescription Drug Claim Forms
To submit an international claim:
To submit a claim for services received when traveling or living outside of the U.S. please follow the directions located on the BlueCard Worldwide section of the Blue Cross Blue Shield Association website.
