Member Reward Forms
Who is this for?
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 a different Entertainment® coupon book.
Blue Advantage Reward forms
- Member Health Evaluation Reward form (PDF)
- Retinal Eye Exam Reward form (PDF)
- Mammogram Reward form (PDF)
- Flu Vaccine Reward form (PDF)
- Diabetes Testing Reward form (PDF)
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, 2015. Fax or mail the forms to us by Jan. 12, 2016.
Not all members are eligible for all rewards. Copays and deductibles might apply to these exams.