| 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 |
| Dental GRID |
Due to a planned data migration beginning Friday, July 11 at 11:00 p.m., and continuing through Monday, July 14 at 8:00 a.m., you may experience a delay in your information appearing on CareFirst portals. We expect that changes to member data will be reflected on the portals by Tuesday, July 15. Your patience is appreciated.
Change Healthcare notifying individuals of data breach. Learn more here.
Dental & Vision Forms
Dental