Member Resources

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 Handbooks

• 2018 Ambetter Member Handbook for Members in the Health Insurance Marketplace (PDF)
• 2018 Ambetter Member Handbook for Members in the Premium Assistance Program (PDF)

Reference Materials

• Find a Provider Guide (PDF)
• Preventive Services Guide (PDF)
• Quality Improvement (QI) Program
• Referral and Authorization Information
• Statement of Non-Discrimination
• 2018 Transparency Notice
• 2019 Transparency Notice
• Where To Go For Care
• Women's Health and Cancer Rights Act Annual Notice
• Find Community Resources

Forms

• Authorization to Disclose Health Information Form (PDF)
• Revocation of Authorization to Disclose Health Information (PDF)
• Grievance and Appeals Form (PDF)
• Member Reimbursement Medical Claim Form (PDF) - Used to submit a paid claim for Out of Country emergency services received from an out-of-network international provider.
• Prescription Claim Reimbursement Form (PDF)
• Transplant Reimbursement Form (PDF)