HealthyBlue Advantage 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
Membership Change Request
If you buy insurance through your employer, please contact your employer to make
changes. Changes will not be processed unless received from your employer.
eBilling (Automatic Debit)
International Claim Form
(For care received out of network area)
Coordination of Benefits
(Update your information on My Account)
Disability Certification
Outpatient Pre-Treatment Initial Authorization
Outpatient Pre-Treatment Re-Authorization
Advanced Directive Information Sheet
Maryland Advance Directive
Continuity of Care