Our most frequently requested forms are available as PDF files. If you do not have Adobe® Reader®, download it free of charge at Adobe's site. Just select and print out the appropriate form below, fill it out, and mail it in.
- Standard Claim Form
- BlueCard Worldwide® International Claim Form
- Request for Coverage for Mentally or Physically Impaired Dependents
- Coordination of Benefits Form
- Medicare Coordination of Benefits Form
- Power of Attorney for Health Care Form — Designate someone you trust to make health care decisions if you are unable to do so. Follow instructions on the form.
- Standard Authorization Form and other HIPAA Privacy Forms
