Member Forms

For plan members with benefits through their workplace  

If you purchased a plan for Individuals and Families  

For plan members with coverage on the National Blue Cross Network  

 

For Veteran Affairs, Canadian Forces and RCMP members

  • Health care providers looking for claim forms for Veterans Affairs Canada (VAC), Royal Canadian Mounted Police (RCMP) or Canadian Forces (CF) members can contact our Federal Administered Programs Department by calling 1-888-261-4033 toll free.
  • RCMP members — must submit a 1393 form available through your detachment. Your completed 1393 form should be sent to:
    RCMP Health Services
    Mailstop #1208
    14200 Green Timbers Way
    Surrey, BC
    V3T 6P3
  • Canadian Forces members contact and submit your claims to your base Health Care Coordinator.

For Travel Claims and Out-of-Country/Province claims  

For Ministry of Social Development & Poverty Reduction or Health Kids Clients

Miscellaneous forms 

Additional Blood Glucose Test Strips

Please have your Endocrinologist or Diabetes Specialist complete this form to request an additional 100 blood glucose test strips, if circumstances warrant a periodic increase in blood glucose testing beyond your annual limit.

Continuous Glucose Monitoring (CGM)

Please have your Endocrinologist or Diabetes Specialist complete these forms to have Continuous Glucose Monitoring (CGM) equipment and supplies reviewed for coverage under your plan.

Flash Glucose Monitoring (Flash)

Please have your Endocrinologist or Diabetes Specialist complete these forms to have Flash Glucose Monitoring equipment and supplies reviewed for coverage under your plan.

 

*Electronic claims service is available to all Individual Plan customers and to group plan members whose plan sponsors/employers have opted to provide this service as part of their benefits plan
.