MHIP Member Information, Links, and Resources

MHIP Documents

Carrier Forms

You must file your claim no later than the end of the calendar year after the year in which you received the services or supplies.

  • MHIP claim Form - This form is to be used when filing for any services received from a non-network provider in the MHIP State Pool. This form should be used for both carriers. There is not a separate form available for Blue Cross and Blue Shield of Kansas City (BCBSKC). To file a claim with BCBSKC, mail the completed form to: Blue Cross and Blue Shield of Kansas City, PO Box 419169, Kansas City, MO, 64179-0147.
  • Enrollee Change Form - Anthem BCBS
    Enrollee Change Form - BCBSKC
    - This form is to be used by MHIP members to update contact information, such as a mailing address. It is to also be used when changing your plan choice during the MHIP's annual open enrollment.
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Apply for MHIP Coverage

Applications accepted until 11-15-13.

It's easy to apply for MHIP coverage. We've put together a simple checklist to help you get all your information in order.

Go to the Apply Now Checklist Page for information and helpful links.

Download the MHIP Application.

Need help with your application?
Call us at 800-821-2231.

Appeals and Grievances

Appeals and Grievances should be filed in accordance with State Pool Certificate of Coverage (page 45).

State Pool Certificate of Coverage