By completing the online enrollment form, you are sending an actual enrollment request to BCBSAZ.
A few quick tips before enrolling...
- Please read this important information.
- Make sure you meet the eligibility requirements.
- Please review the Summary of Benefits and including the Multi-language insert
- You must complete each section before moving to the next one.
- Your enrollment will not be saved until you click the Enroll Now button at the end of the application.
- If you have problems enrolling online you can also:
- If anyone helps you fill out your application, that individual must electronically sign the enrollment form and indicate his or her relationship to you.
- No premium payment is required at the time you join. If you complete a paper application, make a copy of your signed application for your records and the Comprehensive Formulary which tells you about the plan's covered medications.
After you’ve enrolled
BCBSAZ will send you a member ID card and a Welcome Kit with the plan’s Evidence of Coverage that provides a full description of plan benefits.
Note: Do not disenroll from any Medicare Supplement plan, Medigap, or Medicare Select plan until you receive confirmation of approval of your enrollment from BCBSAZ.