Vision Claim Form (Medicare)

Request reimbursement for eligible eye care services you've received. For members of Medicare plans.

Worldwide Emergency or Urgent Care Benefit Claim Form

Use this form to request reimbursement for emergency or urgent care services received outside the United States.

Subscriber Medical Claim Form - Spanish

Formulario de solicitud de reembolso presentado por el miembro

Dental Claim Reimbursement Form (Medicare)

Blue Plus Member Authorization form

Blue Plus Member Appeal Rights Process

Appeals process for the following plans: Blue Advantage Families and Children, MinnesotaCare and Minnesota Senior Care Plus (MSC+)

Prescription Drug Claim Form

Blue Cross and Blue Shield of Minnesota Self-Insured Complaint Form

BCBS and Blue Plus Fully Insured Complaint Form

BCBS Fully Insured Complaint Form