Medical Forms & Info ¦¦ Prescription Forms & Info ¦¦ Misc. Forms & Additional Coverage
Blue Cross/Blue Shield Policy #: P09614 (PPO) B09614 (HMO) OM9616 (Blue Cross Select; BCS)
Contact Information: Blue Cross PPO & BCS member services: 1-800-541-2767 for any claim or benefit questions . Blue Cross HMO Member services : 1-800-892-2803 for any claim or benefit questions . Pharmacy Program: 1-800-423-1973 Mental Health/chemical dependency 1-800-851-7498: Member must call prior to hospital admission or within 1 day of emergency admission. To locate a participating PPO provider in your service area or when traveling : 1-800-810-BLUE (2583) or www.bcbsil.com/providers/index.htm Medical Services Advisory 1-800-232-7108: For all Illinois PPO hospital admissions , hospital must call. For all Illinois HMO, Primary Care Physician will call. For Non-PPO or Out of State Hospital Admissions , member must call three days prior to elective admission and within 1 day of an emergency admission.
Contact Information:
Blue Cross PPO & BCS member services: 1-800-541-2767 for any claim or benefit questions .
Blue Cross HMO Member services : 1-800-892-2803 for any claim or benefit questions .
Pharmacy Program: 1-800-423-1973
Mental Health/chemical dependency 1-800-851-7498: Member must call prior to hospital admission or within 1 day of emergency admission.
To locate a participating PPO provider in your service area or when traveling : 1-800-810-BLUE (2583) or www.bcbsil.com/providers/index.htm
Medical Services Advisory 1-800-232-7108: For all Illinois PPO hospital admissions , hospital must call. For all Illinois HMO, Primary Care Physician will call. For Non-PPO or Out of State Hospital Admissions , member must call three days prior to elective admission and within 1 day of an emergency admission.
Medical FAQ and Forms: All forms in Acrobat .PDF format unless otherwise noted.
Health care costs and helping to keep them affordable Blue Access Information Brochure Sign up for Blue Access for Members: Click Here for the BCBSIL website . BCBS BlueChoiceSelect Benefits Highlights BCBS BlueAdvantage Entrepeneur PPO Benefits Highlights HMO Description of Benefits Back to top
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Prescription Plan and Forms: All forms in Acrobat .PDF format unless otherwise noted.
I Need: What is a formulary? Blue Cross Formulary 2007 To File a Prescription Drug Claim: Blue Cross Prescription drug claim form To Know how to Order Prescription Drugs by Mail Blue Cross Prescription Mail order brochure To Order Prescription Drugs By Mail & Fax the Request: Blue Cross Prescription Mail order enrollment form :for faxing To Enroll in the Prescription Mail Order : Blue Cross Prescription Mail order enrollment form
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Miscellaneous Forms and Info .
I Need: Information on the Vision Plan Metlife Vision Discount Guide Information on the Lasik Vision Correction Discount MetLife Vision Lasik Flyer To Waive Coverage by Blue Cross Blue Cross Waiver form To Enroll in Blue Cross Medical Coverage Blue Cross Enrollment Form To file a Medical Claim Blue Cross Claim Form Information about Medical Coverage while I'm traveling Blue Cross Away From Home Brochure To file a Medical Claim while I'm outside the U.S. BlueCross International claim form Information on Blue Care Connection Blue Care Connection Info