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BluePreferred 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 (MD, DC and Northern VA)
For services received in the MD, DC and Northern Virginia CareFirst service area. |
Medical Claim (Other Service Areas)
For services received in areas other than the MD, DC and Northern Virginia CareFirst service area. |
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) |