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Apply Online

If you would like to apply online to either Blue Cross or Blue Shield, please click on one of the following links below and follow the instructions on the proceeding page.
                                                                       
To apply for Blue Cross Individual Coverage:     Individuals Apply for Blue Cross On-line
To apply for Blue Shield Individual Coverage:    Individuals Apply for Blue Shield On-Line  
                                                                       
If you would like to apply online for short-term coverage, please click on one of the following links below, download the form, complete, and mail (or fax) to the address (or number) listed on the top of the form.
To apply for Blue Shield Short-Term Option One Coverage :      Apply for Short-Term Option One
To apply for Blue Shield Short-Term Option Twelve Coverage:  Apply for Short-Term Option Twelve


 

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