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Access forms for providers

Click on the applicable form, complete online, print, and then mail or fax it to us.

Provider Forms


Member Forms

Florida Blue members can access a variety of forms including: medical claims, vision claims and reimbursement forms, prescription drug forms, coverage and premium payment and personal information.

Medicare Plans

Forms for Florida Blue Medicare members enrolled in BlueMedicare plans (Part C and Part D) and Medicare Supplement plans.


Individual, Family & Employer Plans (non-Medicare)

Forms for Florida Blue members enrolled in individual, family and employer plans.