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Travel forms. For emergency health claims: Travel Insurance claim form. For trip cancellation claims: Trip Cancellation Insurance claim form. For baggage claims: Baggage Benefit claim form.
Manitoba Blue Cross offers a wide range of plans, including health and dental benefits for individuals and groups, travel coverage & life insurance.
Download applicable claim form (s) and once completed and signed: Mail to Manitoba Blue Cross at PO Box 1046 Stn Main, Winnipeg, Manitoba R3C 2X7. Drop it into the secure 24-hour claim box outside our building at 599 Empress Street, Winnipeg, Manitoba. Fax to 204.772.1231.
FAMILY MEMBERS MAY SUBMIT A COMBINED CLAIM. • PLEASE ATTACH ITEMIZED RECEIPTS/INVOICES AND PRESCRIPTIONS/REFERRALS (IF REQUIRED). A COPY OF A VALID PRESCRIPTION IS REQUIRED FOR VISION CLAIMS. • RECEIPTS WILL NOT BE RETURNED.
Frequently used forms. Accidental dental claim form. Dental claim form. Health Spending Account (HSA) claim form. Health benefits claim form (includes vision)
HEALTH SPENDING ACCOUNT CLAIM FORM. CANADA REVENUE AGENCY REQUIRES YOU TO CLAIM ALL MEDICAL EXPENSES THROUGH YOUR PROVINCIAL AND GROUP INSURANCE PLANS BEFORE PAYMENT CAN BE MADE FROM A HEALTH SPENDING ACCOUNT. MEMBER INFORMATION. SERVICE RECIPIENT (PATIENT) INFORMATION. For additional service recipients, please use another claim form.
You must claim all medical expenses through your provincial and group insurance plans before payment can be made from a HealthFDUH Spending Account. Only medical expenses recognized by Canada Revenue Agency are eligible, and payments will only be issued to the member. AUTHORIZATION AND CONSENT.
Download forms. Find commonly used forms to access your benefits and submit claims. View forms list.
If any updates are required in the future to your direct deposit information, you can do so through your mybluecross online account or by submitting a direct deposit form to Manitoba Blue Cross.
GROUP LIFE BENEFIT CLAIM FORM. Page 1 of 2. Blue Cross Life Insurance Company of Canada underwrites all life and disability income benefits. AUTHORIZATION AND CONSENT.
