Member Forms

For plan members with benefits through their workplace  

If you purchased a plan for Individuals and Families  

For clients of the First Nations Health Authority (FNHA)

For plan members with National coverage on My PBC Benefits  

If your membership card looks like this, please go to the My PBC Benefits resource page:
Sample Member ID card for My PBC Benefits


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  

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.

Glucose Monitoring Systems

If this request is for the Dexcom G6/G7 Continuous Glucose Monitor or the FreeStyle Libre 2 Flash Glucose Monitoring System (Libre 2), please have your Prescriber or Diabetes Specialist complete the BC PharmaCare Special Authority form and apply directly to BC PharmaCare on your behalf.

For members residing outside of BC, please have your Prescriber or Diabetes Specialist complete the Dexcom G6/G7/FreeStyle Libre 2 (Libre 2) request form.

For all other Continuous Glucose Monitors (CGM), please have your Endocrinologist or Diabetes Specialist complete these forms to have CGM 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