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Blue Cross Blue Shield

Fill Out Claim Form

BCBS provides two options to submit your claim: State Specific or Standard Claim Form. You can choose option below.

Standard Claim Form:

Download a Universal Claim Form here. Call the Customer Service number on the back of your Health Plan ID Card and ask for the mailing address for claim forms. Complete the claim form above and submit it along with your CPAP.com itemized receipt and prescription to the mailing address identified by your insurance company. The US Expediters, Inc. dba CPAP.com Federal Tax ID is 760521364. You can download more specific instructions (start on page 7) for filling out the claim form here.

Specific Local BCBS Forms:

Download the Specific BCBS Claim form for your local BCBS company. Click here to go to the Blue Cross Blue Shield website. Search for your local BCBS company. Once on that page, use the search field to search for "medical claim form." Download the claim form. Follow the instructions to fill out and submit it along with your CPAP.com itemized receipt and prescription to the address given on the claim form. The US Expediters, Inc. dba CPAP.com Federal Tax ID is 760521364.

Attach Receipt & Prescription

We'll include a receipt with your package, or you can download a copy from your account.

You can download a copy of your prescription from your account.

Submit Claim Form, Receipt and Prescription

Note: Receipts for masks with headgear and machines with humidifiers do not break down the cost separately because they are a packaged item. If your insurance provider has questions, please do not hesitate to reach out to us!

Get Money Back

After submitting your claim, you'll typically be reimbursed within 2-3 weeks. (Depending on your provider, it can be faster or slower.)

Not Your Provider?

If this page doesn't show your insurance provider, click the button below to return to a menu to select the right provider. Claim forms are often specific to each company. You don't want to fill out the wrong one!

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