Medicare Plus Blue℠ PPO

Authorization Agreement for Automatic Withdrawal (PDF)

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Medicare Plus Blue PPO
P.O. Box 44256
Detroit, MI 48244-0256
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Fax: 1-866-533-5810

BCN Advantage℠ HMO and HMO-POS

Authorization Agreement for Automatic Payments (PDF)

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BCN Advantage
Mail Code C415
20500 Civic Center Drive
Southfield, MI 48076-4115