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 1-833-590-3300 (TTY 711).

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