Downloadable Forms for Medicare Products

Here are some commonly used forms for conducting business with Blue Cross and Blue Shield of New Mexico (BCBSNM). To access more downloadable forms, please log in to Blue Access for Producers.

To review and sign your request now electronically, select the sign now option below. Or you can download and save the form, to review and sign at a later date.

Enrollment Forms

Form Name Digital Form Download
Medicare Supplement Applications N/A N/A

 

Medicare Secondary Payer (MSP) Form and Information

Form Name Digital Form Download
Annual MSP Employer Acknowledgement Form (EAF) with Instructions on Completing the Form sign now download form
Information Regarding the MSP Statute N/A download flyer
MSP Fact Sheet N/A download fact sheet

 

Miscellaneous Forms

Form Name Digital Form Download
Medicare Supplement ezBlue Payment Option Authorization Agreement N/A download form
Medicare Coordination of Benefits Form N/A download form