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BlueChoice (HMO) Forms

If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card.

Medical Claim
Membership Change Form for Grandfathered Members of Maryland and Washington, D.C.
Member Update Form for Grandfathered Members of Virginia
eBilling (Automatic Debit)
International Claim Form (For care received out of network area)
Coordination of Benefits (Update your information on My Account)
Disability Certification
Advanced Directive Information Sheet
Maryland Advance Directive
Continuity of Care - Members in a Maryland Based Plan (PDF)