New Medicare Advantage Dental Form and P.O. Box

  • January 21, 2021

    If you provide dental services to a Premera Medicare Advantage member, but you’re not in our Medicare Advantage dental network, you’ll need to do the following to receive payment for your claim:

    1. Fill out our new Medicare Advantage dental claim reimbursement form and send the form and either a completed ADA claim form or itemized statement to the new P.O. Box
      OR
    2. Collect payment from your patient and provide your patient with a completed ADA claim form or itemized statement. Ask them to fill out the new form and send to the new P.O. Box for payment reimbursement.

    New P.O. Box (for dental only)
    Premera Blue Cross Medicare Advantage
    P.O. Box 981743
    El Paso, TX 79998-1743

    New Form
    The form has easy-to-follow instructions and includes the new P.O. Box address for submitting claims. You can find the new form on the member Medicare Advantage additional resources page, under “Common Forms.”

  •    Email this article