This page is a one-stop shop to all things related to forms associated with Farm Bureau Health Plans. You can download and print applications; prescription claims forms, change of coverage forms and more.
Newborn Waiver Form
If you are applying for coverage and are currently
an expectant parent, completion of a Newborn Waiver
form will be required before the application can be processed.
The Newborn Waiver form establishes that the newborn child,
upon delivery, will not have automatic coverage. A new
application to add the newborn child will be required and the child will be underwritten. After the application process is complete, the newborn child will be added to the coverage on the next available effective date.
ACA Bank Draft Authorization Form
If you have an ACA plan (FBHP: Gold, Bronze, Silver or Catastrophic) and need to change your bank information for your monthly premium payment, complete this form, attach a voided check and mail both to Farm Bureau Health Plans.
FBHP ACA-Compliant Change Form
This form allows you to make changes to your current
A Farm Bureau Health Plans Representative is in every Farm Bureau office in all 95 counties of the state.
Farm Bureau Health Plans is proud to offer quality coverage at an affordable cost.
Quality Health Care Coverage at an Affordable Cost!
Farm Bureau Health Plans has a wide range of plans to suit different needs.Download an application to get started.
Thank you for visiting Farm Bureau Health Plans.
If you applied for an ACA plan with coverage effective 1/1/17 and your premium payment has been processed or you have received notification of a late draft date please be assured you have coverage. All ACA ID cards and packets have been mailed and should be received by January 20.
If you have an urgent need for your ID card you may call us at 877-874-8323 and speak with one of our customer advocates or email us at email@example.com.
If you applied for a Traditional Plan which requires medical underwriting, the underwriting process is taking 3 weeks or longer for a decision due to our current volume of applications. If you need immediate coverage you may consider applying for a short term plan. Information on our short term plans is also available on our website.
We apologize for any delays and we are making every effort to respond to phone calls and process applications as quickly as possible.
The ACA Annual Enrollment period ends on January 31, 2017. To ensure a March 1, 2017 effective date, you must submit your ACA Plan application by January 31, 2017 at 11:59 p.m.