Apply Special Care

If you believe you meet the Basic Eligibility Requirements, download an application or call 1-866-282-2702.

Download a PDFSpecial Care application in English.

Follow these important steps:

  • Complete the application.
  • Print clearly and answer all questions.
  • Sign the application.
  • Mail the completed form and all income documentation to:
    Independence Blue Cross
    P.O. Box 13449
    Philadelphia, PA 19101-9552

Remember to sign the application; if it is not signed, the application cannot be processed. If your application is accepted, we will bill you. Send no money now.

If you need help with the application, please call 1-866-282-2702. If you are hearing impaired call TDD 215-241-2622.