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Optional Supplemental Dental, Vision and Hearing Plan Selection Form Date: Member name: Enrolled number: I'd like to add the optional supplemental dental, vision and hearing plan to my base BCN Advantage
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How to fill out Blue Care Network Form:
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Obtain the Blue Care Network form from the official website or local Blue Care Network office.
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Begin by filling out personal information such as name, address, date of birth, and contact details.
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Provide accurate and up-to-date information regarding your current healthcare coverage, if any.
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Indicate whether you are applying as an individual or a family by providing the necessary information for each family member.
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Specify the type of coverage you are seeking - such as health insurance, dental insurance, or vision insurance.
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