Forms

Fitness Benefit
The HUGHP Fitness Benefit provides up to $150 that you or your family may use toward membership or exercise classes at a qualified health club.

HUGHP Claim Form
File the HUGHP Claim Form when you receive a bill for services for which the provider does not directly submit a claim to Blue Cross Blue Shield of Massachusetts.

Medco Prescription Drug Claim Form
File this form to obtain direct reimbursement for prescriptions purchased on or after January 1, 2009.

Out of Country Claim Form
Use the BlueCard Worldwide International Claim Form to submit institutional and professional claims for benefits for covered services received outside the United States, Puerto Rico, Jamaica and the U.S. Virgin Islands.  The International Claim Form must be completed for each patient in full, and accompanied by fully itemized bills.  It is not necessary for you to provide an English translation or convert currency.

Weight Loss Benefit
HUGHP members are eligible for a Weight Loss Benefit that can save you or your family up to $150 per calendar year in qualified weight loss program fees.