FloridaBlue

Florida Blue Medical Forms

Send completed forms via interoffice mail, postal service, or in person, to the County’s benefits coordinator representative listed in this website.

Major Medical Claim

Please contact Steve Manning before any major procedure. Download the claim form below:

Grievance and Appeal Forms

Not HMO: For use with BlueOptions, BlueChoice, BlueSelect, GoBlue or Traditional plans

HMO - Blue Care

Care Centrix

Call on CareCentrix for all your medical equipment, home health services, and infusion therapy needs.

Care Consultation

Sometimes things happen that are beyond our control like accidents, illnesses and emergencies. If your health changes, you need someone on your side to guide you through. That’s what our Care Consultation and Advocacy Program is for.

The Care Consultant Team (CCT) is the heart of the program. Care Consultants offer free advice and support to help you manage your health needs and control your total costs.

Durable Medical Equipment

Durable Medical Equipment is covered when provided by a Durable Medical Equipment Provider and when prescribed by a Physician and is limited to the most cost effective equipment as determined by FloridaBlue

Insurance Cancellation Form

Please fill out a form for EACH Insurance Product you wish to cancel and provide to HR

Diabetic Supplies

To aid your transition, we want to provide you with instructions on how to best obtain your diabetes supplies using your Florida Blue plan.

Prior Authorization

Please note that Prior Authorization requirements may vary and member benefits and contract will prevail. If you have questions or need further assistance after consulting this table, call our Provider Contact Center or the number on the back of your insurance card.