Fast forms – online
Managing your health coverage plan is easy with your Blue KC member account. Speed through the process of submitting insurance claims online and get reimbursed faster. If you don’t yet have a member account, create an account first.
The following forms can be found inside your member account:
- Medical/Dental Claims
- Pharmacy Claims
- Blue Cross and Blue Shield Global Core International Claims
Prefer to submit your health insurance claim by mail?
Note: Review of your form and potential reimbursement will be slower than online submissions.
- Medical/Dental Claim Form
- Claim Inquiry Form
- Pharmacy Claim Form
- Blue Cross Blue Shield Global Core International Claim Form
- Travel Benefit Claim Form (Review your benefit documentation or call Customer Service to confirm eligibility)
Applications
- Dental Product Application
- Spanish Language Dental Product Application
- Medicare Supplement Application
Member Forms
- Complaint/Grievance
- 1095 A, B, & C Forms – See Frequently Asked Questions below
Short-Term Plan Applications
- Short-Term Plan Application (up to 90 days without Rx)
- Spanish Language Short-Term Plan Application (up to 90 days without Rx)
Prior Authorization
1095 Frequently Asked Questions
1095 Form
If Blue KC has a SSN on file, that is what we are required to use for the 1095-B form. The IRS will match the 1095-B form with your individual tax returns; whatever number you use on your individual tax forms is what will be used to match the 1095-B.
To make corrections to your form, please contact the following:
- 1095-A: Call the Exchange at 1-800-318-2596.
- 1095-B: If you purchased your insurance directly from Blue KC, call us at the number listed on your member ID card. If your insurance is provided by your employer, make the corrections with your employer, who will then inform us of the changes and an updated 1095-B will be sent.
The annual deadline for the Marketplace to provide Form 1095-A is January 31. The deadline for insurers (including Blue KC), other coverage providers and certain employers to provide Forms 1095-B and 1095-C to individuals is January 31.
There are two types of 1095 forms:
- 1095-A: If you bought your Blue KC health insurance from the Health Insurance Marketplace (Exchange), you will receive form 1095-A. If you need to make corrections, or request a duplicate copy, please contact the Exchange at 1-800-318-2596.
- 1095-B: If you or your employer purchased health insurance directly from Blue KC (not through the Exchange) you will receive form 1095-B from Blue KC.
The 1095 form is used to report your insurance coverage to the IRS. The Affordable Care Act requires all individuals to have health insurance coverage unless they qualify for an exemption.
You will use the information on the 1095 form to verify that you, your spouse and/or any dependents had coverage for each month during the year.
We also encourage you to consult your tax adviser and refer to the 1095 Q&A on the IRS website for more information about the use of the 1095 forms.
You do not need to submit the 1095 form with your tax return; it is provided for your reference and should be retained with your other important documents.
The Health Insurance Marketplace provides access to Form 1095-A online at healthcare.gov in mid to late January. These forms are also mailed to policyholders no later than mid-February.
Blue KC allows members to request 1095-B forms for the previous year at the end of January. Employers with 50 or more employees are required to send out a 1095-C, and we recommend you check with your employer about associated timelines.
To request a duplicate 1095 form, please contact the following:
- 1095-A: Call the Exchange at 1-800-318-2596.
- 1095-B: Call Blue KC at the number listed on your member ID card.
If Blue KC has a SSN on file, that is what we are required to use for the 1095-B form. The IRS will match the 1095-B form with your individual tax returns; whatever number you use on your individual tax forms is what will be used to match the 1095-B.
You should receive a 1095 form from any company that provided you with minimum essential coverage during the prior year.
In addition, there may be corrections to your information that prompt a revised 1095-B form to be created. Following is a list of reasons why you might receive an updated 1095-B form:
Blue KC received information from your employer informing us of a change to:
- Who was covered on your policy
- The coverage dates for those covered on your policy
- SSNs for those covered on your policy
- Dates of birth for those covered on your policy
- Your Employer’s Employer Identification Number (EIN).
Blue KC received corrected information from you regarding:
- Who was covered on your policy
- The coverage dates for those covered on your policy
- SSNs for those covered on your policy
- Dates of birth for those covered on your policy
No. All individuals covered on your policy will appear on a single form that is mailed to the subscriber (policyholder) of the Blue KC policy. The 1095 does not need to be submitted with an individual’s tax return.
If Blue KC has a SSN on file, that is what we are required to use for the 1095-B form. The IRS will match the 1095-B form with your individual tax returns; whatever number you use on your individual tax forms is what will be used to match the 1095-B.
To make corrections to your form, please contact the following:
- 1095-A: Call the Exchange at 1-800-318-2596.
- 1095-B: If you purchased your insurance directly from Blue KC, call us at the number listed on your member ID card. If your insurance is provided by your employer, make the corrections with your employer, who will then inform us of the changes and an updated 1095-B will be sent.
The annual deadline for the Marketplace to provide Form 1095-A is January 31. The deadline for insurers (including Blue KC), other coverage providers and certain employers to provide Forms 1095-B and 1095-C to individuals is January 31.
There are two types of 1095 forms:
- 1095-A: If you bought your Blue KC health insurance from the Health Insurance Marketplace (Exchange), you will receive form 1095-A. If you need to make corrections, or request a duplicate copy, please contact the Exchange at 1-800-318-2596.
- 1095-B: If you or your employer purchased health insurance directly from Blue KC (not through the Exchange) you will receive form 1095-B from Blue KC.
The 1095 form is used to report your insurance coverage to the IRS. The Affordable Care Act requires all individuals to have health insurance coverage unless they qualify for an exemption.
You will use the information on the 1095 form to verify that you, your spouse and/or any dependents had coverage for each month during the year.
We also encourage you to consult your tax adviser and refer to the 1095 Q&A on the IRS website for more information about the use of the 1095 forms.
You do not need to submit the 1095 form with your tax return; it is provided for your reference and should be retained with your other important documents.
The Health Insurance Marketplace provides access to Form 1095-A online at healthcare.gov in mid to late January. These forms are also mailed to policyholders no later than mid-February.
Blue KC allows members to request 1095-B forms for the previous year at the end of January. Employers with 50 or more employees are required to send out a 1095-C, and we recommend you check with your employer about associated timelines.
To request a duplicate 1095 form, please contact the following:
- 1095-A: Call the Exchange at 1-800-318-2596.
- 1095-B: Call Blue KC at the number listed on your member ID card.
If Blue KC has a SSN on file, that is what we are required to use for the 1095-B form. The IRS will match the 1095-B form with your individual tax returns; whatever number you use on your individual tax forms is what will be used to match the 1095-B.
You should receive a 1095 form from any company that provided you with minimum essential coverage during the prior year.
In addition, there may be corrections to your information that prompt a revised 1095-B form to be created. Following is a list of reasons why you might receive an updated 1095-B form:
Blue KC received information from your employer informing us of a change to:
- Who was covered on your policy
- The coverage dates for those covered on your policy
- SSNs for those covered on your policy
- Dates of birth for those covered on your policy
- Your Employer’s Employer Identification Number (EIN).
Blue KC received corrected information from you regarding:
- Who was covered on your policy
- The coverage dates for those covered on your policy
- SSNs for those covered on your policy
- Dates of birth for those covered on your policy
No. All individuals covered on your policy will appear on a single form that is mailed to the subscriber (policyholder) of the Blue KC policy. The 1095 does not need to be submitted with an individual’s tax return.