Forms | Notifications | Flyers

Appeal an Adverse Claim Determination

Breast Pump Claim Form

Coordination of Benefits

GlobalCore with Claim Form

Prescription Drug Claim Form

Basic Plan Acknowledgement

Domestic Partner Form

Impaired Dependent Declaration

Statement of Common Law Marriage

NEW! Voluntary Life

Dearborn Life Claim Form

Dearborn Long Term Disability Claim Form

Ancillary Coronavirus Coverages with New Coronavirus Support and Resources Hotline

Dearborn Handling of Not Actively at work Employees with Life Coverage

Portability and Conversion Overview

Click HERE for Understanding Your Insurance—Life and LTD flyer

Click HERE for Life and LTD policy documents

For an Evidence of Insurability form, please contact MUST at 800.845.7283.

Welcome Packet: MUST administers WHCRA, COBRA, and HIPPA provisions for continuation of coverage.

HIPAA Notice MUST is fully compliant with the privacy and security provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Women’s Health and Cancer Rights Notice

Added Value Program Flyers and Presentations

 Understanding Your Insurance – Life & LTD (trifold)

Understanding Your Insurance – Alternate Ways to Access Care (trifold)

Understanding Your Insurance – Navigating your Pharmacy Benefit (trifold)

24/7 Nurseline

BCBSMT Mobile App

Blue Access for Members

BCBSMT Air Ambulance In-Network Services

Premise Health Center Services

Blue Access for Members (BAM)

Blue365

Making MUST Health Insurance Solutions Work for You

Pharmacy Benefit

Provider Finder Pricing Tool

MUST Virtual Visits