If you have one of our Medicare Plus Blue PPO plans and want to access your own PHI or share it with someone you designate, you can fill out this digital form.
If you have one of our BCN Advantage HMO or HMO-POS plans and want to access your own PHI or share it with someone you designate, you can fill out this digital form.
If you have one of our Medicare supplement plans and want to access your own PHI or share it with someone you designate, you can fill out this digital form.
This form lets you pick a person like a spouse, friend, family member, lawyer or caregiver to act on your behalf regarding Medicare coverage decisions, appeals and grievances. Note: You can't pick a law firm or group to help you.
If you have dental coverage with us through your Medicare Advantage plan and want reimbursement for a covered dental service, download and send this form.