Forms
- Enrollment and Change Form 2024-2025 (pdf) (Our office cannot accept forms with credit card information by email. Please post-mail, deliver the form in person at the address listed at the bottom of the form, or call 612-624-0627 to provide card info over the phone.)
- Dental Reimbursement Form 2024-2025 (pdf)
- Department Authorization Form 2024-2025 (pdf) (for fellows and trainees only)
- Student Information Release Authorization Form 2023-2024 (pdf)
- Continuation of Coverage Form 2024-2025 (pdf) (Our office cannot accept forms with credit card information by email. Please post-mail, deliver the form in person at the address listed at the bottom of the form, or call 612-624-0627 to provide card info over the phone.)
Brochures
- Enrollment Brochure (pdf)
- Summary Plan Description: Plan 1 (pdf)
- Summary Plan Description: Plan 2 (Dependents Only) (pdf)
- Summary of Benefits & Coverage: Plan 1 (pdf)
- Summary of Benefits & Coverage: Plan 2 (Dependents Only) (pdf)
Blue Cross Online Portal
The online member portal offers one-stop convenience for all your health plan information, allowing you to:
- View your member ID card or order a replacement
- View claims and plan information
- Search for a network doctor, clinic, or hospital, by selecting the "Blue Cross AWARE" network
- Find estimated costs for common medical procedures
- Read and write patient reviews on medical providers
Member ID Mobile App
Access important health plan information wherever and whenever you want with the BlueCrossMN Mobile app. You’ll have convenient, on-the-go access to claim status, your member ID card, a search tool to find in-network care and more, including other health resources like Sharecare. Search for “BlueCrossMN Mobile” in your app store.