Forms
Welcome to the DMC Care Forms for KCI Employees!

 Coordination of Benefits (COB)

Direct Reimbursement
Medical and Value Options (BHSA)

Direct Reimbursement - Pharmacy 

Cordination of Benfit (COB) On-line Form 

 Out-of-Network Reimbursement Form

Navitus DMR Form - If you need reimbursement on a purchased drug, please submit a Direct Member Reimbursement (DMR) form.








If you have any questions regarding the DMC Care forms, please contact a DMC Member Services Representative toll-free at (800) 543-0161.

Also, feel free to contact Member Services via the Contact DMC Care On-line form.

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DMC Care Customer Service
(800) 543-0161

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Detroit Medical Center Pencil