Many of our member resources, such as the member handbook and forms, can be found on our secure portal.  Click Login to create an account and access a wide array of resources!

Member Handbook

• 2019 Ambetter Member Handbook (PDF)

Reference Materials

• Doctor's Office Visit Checklist (PDF) - Use this checklist to get prepared for your next doctor's appointment. 
• Statement of Non-Discrimination
• 2020 Transparency Notice
• 2019 Transparency Notice
• Preventive Services Guide (PDF)
• Where to go for Care
• Women's Health and Cancer Rights Act Annual Notice
• Member Appeals

Forms

• Authorization to Disclose Health Information Form (PDF)
• Member Reimbursement Medical Claim Form (PDF) 
• Continuity of Care Assistance Form - English (PDF)
• Continuity of Care Assistance Form - Spanish (PDF)
• Coordination of Care Form (PDF)
• Prescription Claim Reimbursement Form (PDF)
• Grievance and Appeals Form (PDF)
• Appointment of Representative Form (PDF)