Forms

Click on the links below to download forms you may need.

BlueCHiP for Medicare Forms - Visit the BlueCHiP for Medicare webpage to download forms you may need as a member.

Plan 65 Forms - Visit the Plan 65 webpage to download forms you may need as a member.

Blue MedicareRx℠ (PDP) Forms - Visit the Blue MedicareRx site to download forms you may need as a member of that plan.

 

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Blue Cross & Blue Shield of Rhode Island is a Medicare Advantage organization with a Medicare contract.

Last updated: 05/08/2017

H4152_2017web8 Approved

Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal.