Forms and Documents

Member Handbook for Blue Cross Community Health Plans (BCCHP)
English – Spanish – Arabic – Gujarati – Polish – Ukrainian

Member Handbook for Health Benefits for Immigrant Adults/Seniors (HBIA/HBIS) 
English – Spanish – Arabic – Gujarati – Polish – Ukrainian

Member Handbook for Managed Long Term Supports and Services (MLTSS)
English – Spanish – Arabic – Gujarati – Polish – Ukrainian

OTC Benefits Catalog for BCCHP and HBIA/HBIS

OTC Benefits Catalog for MLTSS

Preferred Drug List (PDL) for BCCHP and HBIA/HBIS  

Pharmacy Directory for BCCHP and HBIA/HBIS

To download medical provider directories for all plans, go to Find a Provider.

LTSS Waiver Handbook
English – Spanish – Arabic – Gujarati – Polish – Ukrainian

Brain Injury Waiver Handbook

Disabilities Waiver Handbook

Elderly Waiver Handbook

HIV/AIDS Waiver Handbook

Supportive Living Waiver Handbook

Things to Know About BCCHP Waivers

Resource Guide for Health Benefits for Immigrant Adults/Seniors (HBIA/HBIS)

Illinois Department of Children and Family Services (DCFS) Youth In Care Program Flier for all plans 
English – Spanish – Arabic – Gujarati – Polish – Ukrainian

Illinois Statutory Short Form – Power of Attorney for Health Care

Please mail your completed form to:

Blue Cross Community Health Plans
C/O Member Services
P.O. Box 3418
Scranton, PA 18505

You must also file a copy with the Illinois Department of Healthcare and Family Services (HFS). Please contact HFS to learn how.

Frequently Asked Questions

HIPAA Notice of Privacy Practices

Member Rights and Responsibilities

Non-Discrimination Notice and Language Assistance