When you get care from an in-network doctor or facility, the provider will submit your claim to Anthem Blue Cross. However, there may be some situations where you will need to submit a claim form, such as when you see an out-of-network provider. Select the appropriate form below, complete it, attach all required documentation and submit everything to the address indicated on the form.
Medical and Behavioral Health Claim Forms
- Medical Claim Form [PDF]. Use this form to submit a claim when your provider does not bill Anthem Blue Cross directly, such as when you use out-of-network providers. You can also submit out-of-network claims online. Log on to Anthem > My Plan and choose "Claims" from the drop-down menu. Scroll to the "Submit a Claim" button at the bottom of the page. Enter the requested contact and claims information and submit.
- International Medical Claim Form [PDF]. Use this form if you paid out of pocket for a covered service received outside of the U.S.
Pharmacy Claims Form
- Pharmacy Claim Form. Use this direct reimbursement form when you have used a non-network pharmacy, or when you did not present your ID card at a network pharmacy during the first 30 days of eligibility.
Manage Claims Online
Access claims—for the entire family—by logging in to Anthem.