Grandfathered Plan Medical Forms

These forms are to be used if you have a "grandfathered" plan, an individual or family plan into which you enrolled before the Affordable Care Act was signed into law on March 23, 2010.

  • If you are unsure of the plan you have, look on your Member ID card. You may contact Member Services by calling the telephone number on your card.
  • Other Member Services contact numbers are also available.

Reinstatement Request

View Form
For members who purchased their plan directly from CareFirst and not through a state Exchange.
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