How to Enroll

Print an enrollment form - complete in black ink and fax or mail in.

Be sure to complete all information, sign and date your enrollment form.
Do not include payment with the enrollment form.
Submit the completed enrollment form: choose one
1. Fax the completed form to: 706 243-4218 or
2. Mail to:

Blue MedicareRx
P.O. Box 9282
Oxnard, CA 93031-9282

BlueCross will contact you in writing when they receive your enrollment form.

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Anthem Insurance Companies, Inc (AICI) is the legal entity under contract with the Centers for Medicare and Medicaid Services (CMS) authorized to offer the applicable Medicare Prescription Drug (Part D) plans and services in this region. AICI is the legal entity licensed under applicable state law or under a federal waiver program that is authorized to offer these Part D plans. AICI has partnered with its affiliated local companies to provide various administrative and management services for these Part D plan(s).

How to Enroll Print an enrollment form - complete in black ink and fax or mail in. Be sure to complete all information, sign and date your enrollment form. Do not include payment with the enrollment form. Submit the completed enrollment form: choose one 1. Fax the completed form to: 706 243-4218 or 2. Mail to: Blue MedicareRx P.O. Box 9282 Oxnard, CA 93031-9282 BlueCross will contact you in writing when they receive your enrollment form.
	You will need Adobe Reader to view PDF documents. Download a copy of Adobe Reader from the Adobe Website.