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 is next.

Do you have a question or need help with a form? Call Member Services at 1-833-282-2252 (TTY 711).

• Authorization for Disclosure of Health Information (PDF)
• Evidence of Coverage (PDF) coming Fall 2025
• Member Handbook (PDF) coming Fall 2025
• Member Reimbursement Medical Claim Form (PDF)
• Member Welcome Brochure (PDF) coming Fall 2025
• Personal Representative Request Form (PDF)