Forms to Help You Enroll

These forms will help you prepare for the enrollment process or assist you as you complete the application process.

Claims Forms

As long as you use network providers, your provider will file claims on your behalf. These forms are designed for unique situations where an out of network provider is used or there is a dispute over a claim.

Appeals Forms

Other Forms


Find a Doctor or Hospital

Find a primary care provider, specialist, hospital, specialty facility, or medical equipment provider for you or your family member.

Find a Provider

Pharmacy Information

When you understand how to maximize your prescription drug benefits, it can help save time and money.

Using a network pharmacy means you don't have to complete any claim forms. Search for a network pharmacy in your area.

Explore Pharmacy Resources

Sign up for MyWellmark

Life can get pretty hectic, and Wellmark wants to help you simplify. With myWellmark, you can access all your health information in one place. It's help for better health. Here are just a few of its benefits:

  • Check claims. Find out the status of a claim.
  • Track health care costs. Run reports to see how much you've spent out-of-pocket.
  • Find out what's covered. See how much your plan will cover for certain services.
  • Compare prescription prices. See what you'll save with generics.
  • Get digital Explanation of Benefits (EOB) statements. Sort EOBs by date, provider and patient.

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