Vision Direct Reimbursement Claim Form

Member Dental Claim Form

2026 Spanish Over the Counter (OTC) Allowance benefit catalog

2026 Catálogo de Artículos de Medicare de Venta Libre (OTC)

2026 Over the Counter (OTC) Allowance benefit catalog

For Medicare Advantage, Group Medicare Advantage and Platinum Blue (Cost) plans.

2026 SecureBlue Formulary (Drug List)

2026 Platinum Blue Core Formulary

List of covered drugs.

2026 Medicare Advantage and Platinum Blue Choice and Complete Formulary

List of covered drugs.

2026 Medicare Advantage Core and Comfort Formulary

List of covered drugs.

2026 Group Medicare Advantage Standard Formulary

For Group Medicare Advantage (PPO) Classic Rx2, Select Rx 2, Select Rx 3, Premier Rx 2, Premier Rx 3, Elite plans

2026 Group Medicare Advantage Value Formulary

For Group Medicare Advantage Classic Rx 1 and Value Rx 4 (PPO) plans