
Apply online – it's virtually paperless and takes only minutes to complete! Click the "Enroll Now" button to get started.
Or you can download, print and fill out the Blue Medicare Rx Plan enrollment form (PDF).
Complete all sections of the form following the instructions outlined on the form.
Mail the completed form to the following address:
BCBSNC Enrollment
P.O. Box 17168
Winston-Salem, NC 27116
You should receive your membership information and your BCBSNC ID card in about 10 to 14 days after your application has been received.
If you need assistance filling out the application, please call an authorized agent toll free at 1-800-478-0583, 7 days a week, from 8:00 a.m. to 8:00 p.m.
For more information, you can download and print the following documents for future reference:
Individuals with limited income and resources may qualify for extra help. Learn more about financial assistance, and get answers to other common questions, in our frequently asked questions.
To view PDF documents you need Adobe Acrobat
Reader.
BCBSNC is a prescription drug plan sponsor with a Medicare contract. Prescription drug coverage is not sold as a benefit of any Medicare supplement plan.
The information on this page is current as of 05/01/2010.
© , Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.