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Click ‘Get Form’ to open the anthem blue continuity form in the editor.
Begin by filling in your Policy Number and Policy Title at the top of the form. This information is crucial for identifying your specific coverage.
In the 'Products' section, indicate which Anthem Blue Cross products apply to you, such as HMO, PPO, or EPO.
Provide detailed information about your current medical situation in the 'Continuity of Care' section. Specify if you are undergoing treatment for an acute condition, chronic illness, or if you are pregnant.
Complete all personal details including Subscriber’s Name, Anthem Blue Cross ID number, and contact information. Ensure no fields are left blank; use 'N/A' where applicable.
Review your entries for accuracy before submitting. Once completed, save your form and submit it through our platform for processing.
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We serve our members as the Blue Cross licensee for California and as the Blue Cross and Blue Shield, or BCBS, licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (in the New York City metropolitan area and
Did Anthem merge with Blue Cross?
Anthems Medicare Advantage HMO plans, formerly MediBlue plans, help you save money with no or low plan premiums. Choose an Anthem HMO plan if you want all-in-one coverage that includes Original Medicare (Medicare Parts A and B) and usually Medicare Part D (prescription drug) coverage.
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Related links
Group Termination Continuity of Care Request Form
Complete and submit a Continuity of Care Request Form if your Anthem health plan ended because your employers contract with us terminated.
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