Resources & Forms

Need help with an Out-of-Network claim?

When you receive care, a claim form must be submitted to CareFirst. In most cases, your in-network provider will submit that claim for you. If you are seeing an out-of-network provider, you may need to submit a claim form.

Claims can be submitted online by logging into My Account, clicking "Claims" and then selecting "Submit a Claim Form Online."

If you need help submitting a claim, contact Member Services at 800-628-8549.

Claim Forms

	BlueChoice Claim Form (PDF) This link opens in a new window.
	Major Medical Claim Form (for 65+) (PDF) This link opens in a new window.
	Pharmacy Claim Reimbursement Form - For Associates (PDF) This link opens in a new window.
	Pharmacy Mail Order Service Form for Associates- For Associates (PDF) This link opens in a new window.
	Prescription Drug Claim Form - For Doctors (PDF) This link opens in a new window.
	Prescription Mail Order Form - For Doctors (PDF) This link opens in a new window.
	Dental Claim Form (PDF) This link opens in a new window.