Do you or your dependent have additional health care coverage? If so, please use this form to report your additional coverage to BCBSND for Coordination of Benefits (COB). You do not need to report dental or vision coverage.
If you have more than two other medical insurance to report, please call the number on the back of your ID card.
Medicare or Medicaid Member?
Login to the portal, to report dual coverage. Click on the 'Your Coverage' tab, choose 'Review your Member Information', then 'Other Insurance Information' and complete the form.
