Forms and Documents

This page includes important forms and documents to help you get the most out of your AmeriHealth Caritas Next plan for now and whatever comes next.

Do you have a question or need help with a form? Call Member Services, 1-833-590-3300 (TTY 711), Monday through Friday, 8 a.m. to 8 p.m.

• Authorization for Disclosure of Health Information (PDF)
• Evidence of Coverage (PDF)
• Member Handbook (PDF)
• Member Reimbursement Medical Claim Form (PDF)
• Personal Representative Request Form (PDF)