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Materials and forms

Here, you’ll find the info and forms you need to get the most from your plan.

Member handbooks


Medicaid Managed Medical Assistance (MMA) and Long-Term Care (LTC) member handbook ― English (PDF) | Spanish (PDF)


Florida Healthy Kids (FHK) handbook ― English (PDF) | Spanish (PDF)



Authorization to release protected health information (PHI) — English (PDF) | Spanish (PDF) | Creole (PDF)


Authorization to release psychotherapy notes — English (PDF) | Spanish (PDF) | Creole (PDF)


PHI access request — English (PDF) | Spanish (PDF) | Creole (PDF)


Request an accounting of disclosures of PHI — English (PDF) | Spanish (PDF) | Creole (PDF)


Fraud, waste and abuse form

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