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BlueChoice Opt-Out Plus Claim 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. |
| 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) |
| Continuity of Care BC - Provider Not in Network (PDF) |