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This form gives us information about any other health coverage our members may have that can affect how we pay benefits. And now, members can complete it online!

In the past, you could only mail or fax us completed questionnaires. This took time, and could delay payment for services. Now, members can access the form by logging into the Member My Insurance Manager. It's easy to use and helps speed up claims processing. You can access both the Other Health Questionnaire, including Medicare, and the Other Dental Coverage Questionnaire.

If you'd still prefer a hard copy, you can get it here:

BlueCross BlueShield of South Carolina

Please note: FEP Members do not currently have access to this form in My Insurance Manager and will need to complete this form.

Federal Employee Program (FEP)