Helpful Forms

Add Dependent Form
Use this form if you already have a policy with BCBSRI and need to add a new dependent (e.g. newborn, spouse, etc.).
Dependent Addendum for Individuals and Families
If the Health and Dental application for individuals and families does not accommodate all of your dependents, please use this form in addition to the application.

Dental
Free coupon for expecting BCBSRI Dental members.
Studies have shown that it’s important for pregnant women to receive regular dental care—that is why pregnant Blue Cross Dental members are eligible for one extra dental cleaning per year by clicking on the link below.