To apply for coverage please use the form listed below to begin the process. If you have questions regarding HIP, e-mail us at IndFamilyRep@bcbsks.com or call 1-800-641-1019, or 291-4306, in Topeka.
Mail your application to:
Blue Cross and Blue Shield of Kansas
Individual Sales Dept.
PO Box 517
Topeka, KS 66601-9834
Or Fax to: 785-290-0716
This form can be completed and printed using your Web browser and the Adobe Acrobat Reader program.