Prepaid Medicine Individual Forms

If you have an Individual Prepaid Medicine plan, you can always access your forms and easily share them via WhatsApp or email.

National Individual Plan Forms

Documents for the BMI Unique international individual plans. For the forms to work properly, we recommend using the Mozilla Firefox, Microsoft Edge or Safari browsers.

International Individual Forms

Documents for the BMI Unique international individual plans. For the forms to work properly, we recommend using the Mozilla Firefox, Microsoft Edge or Safari browsers.

Prepaid Medicine Individual Forms

National Individual Plan Forms

Individual Plan Enrollment Application

Debit Authorization

Customer Service Form

Medical Expense Pre- and Post-Notification Form

Medical Expense Reimbursement Form

Application for Adding Dependents

Cancellation letter

Budget Review Form

International Individual Forms

Individual plan enrollment application

Legal Entity Onboarding Form Igualas Médicas

Individual Onboarding Form Igualas Médicas

Medical Expense Pre- and Post-Notification Form

Medical Expense Reimbursement Form

Application for Adding Dependents

Debit Authorization

Cancellation Letter

Not sure which form you need? Our service team supports you with every request.