Information Regarding Johns Hopkins Notice

Dental & Vision Forms

Dental

Dental Claim Form (all dental plans)

Member Termination Form

Transition of Dental Care Form

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

Coordination of Benefits Form

Vision

Davis Vision (BlueVision, BlueVision Plus)

Coordination of Benefits Form

Davis Vision Out-of-Network Form