Applying for a BluePartner policy is easy. All you do is:

• Review the BluePartner options available to you.
• Choose the plan that's right for you.
• Complete the BluePartner application .
• Calculate your monthly premium for BluePartner. [ 0.1 MB ]
• Mail your completed application and questionnaire to the address listed below. Include a check for your first month's premium.
  
  BlueCross BlueShield of Tennessee
  Attention: Individual Sales - 3G2
  Dept. W
  801 Pine Street
  Chattanooga, TN 37402-2555
  

Your acceptance will be based on the information you provide. You must meet height/weight guidelines and minimum health requirements before your application can be accepted. Once accepted for coverage, your premiums cannot be increased due to changes in your health or the number of claims you file. Your rate is guaranteed for the first year of your coverage.

BluePartner Application [.05 MB ]
Use this form to apply for BlueCross BlueShield of Tennessee's BluePartner plan.

Waiver of HIPAA Rights Form [0.5 MB ]
Notice of Rights under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

How HIPAA Affects Individual Coverage [.3 MB]

Notice of Privacy Practices [.04 MB]