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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)

Forms

Authorization to release protected health information (PHI) (PDF)

Authorization to release psychotherapy notes (PDF)

PHI access request (PDF)

Request an accounting of disclosures of PHI (PDF)

Fraud, waste and abuse form

Caregiver resources

Support groups (PDF)

Caregiver support kit (PDF)