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Prescription Drug Plan Documents

View these forms and documents in Spanish.

Current members can also view forms and documents by logging into Blue Access for Members.

View these forms and documents in English.

Current members can also view forms and documents by logging into Blue Access for Members.

If you decide to work with an agent or broker, they MUST be certified to sell Medicare Advantage, Medicare Advantage Prescription Drug or Prescription Drug plans.

To find your plan specific documents, complete the form below.

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Plan Year

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Current Members can find your plan name on your member ID card (Health Insurance card).

Please complete the form above to view plan information for your ZIP code.

Last Updated: Dec. 01, 2023