Medicare Pharmacy Forms

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Use this form if you'd like to get prescriptions by mail through Optum Home Delivery. Keep in mind it takes about five days for us to fill your order and get it to you.

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You can also get prescriptions by mail through AllianceRx Walgreens. Keep in mind it takes about five days for us to fill your order and get it to you.

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If you have a 2023 individual Medicare Advantage or Part D prescription drug plan with us, you can find a pharmacy with this directory.

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If you have a 2023 Blue Cross Medicare Advantage or Part D prescription drug plan from your employer, you can find a pharmacy with this directory.

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If you have a 2024 individual Medicare Advantage or Part D prescription drug plan with us, you can find a pharmacy with this directory.

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If you have a 2024 Blue Cross Medicare Advantage or Part D prescription drug plan from your employer, you can find a pharmacy with this directory.

Whether it is a doctor, pharmacy, dentist, or vision provider you need, Blue Cross Blue Shield of Michigan Medicare members can find quality providers here.

ONLINE FORM

If you want Blue Cross to make an exception for a drug, you can ask us for a coverage determination. You'll need information about the drug you want covered and the name and contact information of the doctor who prescribed the drug.

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You can also fill out and mail this form to ask for an exception for a prescription drug.

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If you have a Medicare Plus Blue PPO or Prescription Blue PDP plan and want to appeal a decision we've already made about a prescription drug, you can ask us to review it with this form. If possible, include the letter you received from us that you'd like to appeal.

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If you have a BCN Advantage HMO or HMO-POS plan and want to appeal a decision we've already made about a prescription drug, you can ask us to review it with this form. If possible, include the letter you received from us that you'd like to appeal.