The easy-to-use Form Finder from Blue Cross and Blue Shield of Montana is now home to over 900 forms for producers, employers and members. Form Finder is the source of truth for nearly all BCBSMT forms.
The easy-to-use Form Finder from Blue Cross and Blue Shield of Montana is now home to over 900 forms for producers, employers and members. Form Finder is the source of truth for nearly all BCBSMT forms.
Form Name | Digital Form | Download |
---|---|---|
2025 Individual Paper Application Checklist | N/A | download form |
2025 Individual Health Plan Application/Change in Coverage (Off Exchange) Use this form to apply for a BCBSMT Individual Health Plan (Off Exchange) effective January 1, 2025, or to make changes to an existing BCBSMT policy. For individuals under age 65. |
N/A | download form |
2025 Individual Dental Plan Application/Change in Coverage Use this form to apply for a BlueCare Dental Individual Plan effective January 1, 2025, or to make changes to an existing BCBSMT policy. |
N/A | download form |
2025 Individual Paper Application Overflow Page | N/A | download form |
Auto Bill Pay – Automatic Premium Payment Authorization Agreement Reduce the chance of your policy being cancelled for non-payment. Members can use this form to set up electronic payments for their plan. This will allow BCBSMT to deduct the monthly premium from their checking or savings account. |
N/A | download form |
Disabled Dependent Authorization Form (for Individual Plans) Members with an Individual health plan should use this form to request continuation of coverage on their existing policy for a dependent who is incapable of self-support because of mental or physical impairment. Mail or fax the completed form to BCBSMT (see address and fax number at the top of the form). |
N/A | download form |
UW15A – Potential Employer Contribution Form 1 | N/A | download form |
UW15B – Potential Employer Contribution Form 2 | N/A | download form |
Form Name | Digital Form | Download |
---|---|---|
Claim Form – Dental Use this form to file dental claims for reimbursement that are not filed by your dental provider. |
N/A | download form |
Claim Form – Medical (Domestic) Use this form to request reimbursement for health care services obtained within the United States, a U.S. territory, when on a cruise ship, or on a U.S. military base. |
N/A | download form |
Claim Form – Medical (International) Use this claim form to request reimbursement for health care services obtained when traveling internationally – when outside of the United States or a U.S. territory, but NOT for services obtained on a cruise ship or a U.S. military base. |
N/A | download form |
Health Fair, Lab and Immunization Submission Form Use this form to submit preventative immunization or laboratory services received at a Heath Fair, a City/County Health Department, Pharmacy, etc. Include a receipt or itemized statement. |
N/A | download form |
Form Name | Digital Form | Download |
---|---|---|
Producer of Record Transfer Form and Instructions | N/A | download form |
Last Updated: April 02, 2025