Forms and Documents

This page includes important forms and documents to help you get the most out of your First Choice Next plan for now and whatever is next.

Do you have a question or need help with a form? Call Member Services at 1-833-983-7272 (TTY 711).

• Authorization for Disclosure of Health Information (PDF)
• 2025 Evidence of Coverage (PDF)
• 2024 Evidence of Coverage (PDF)
• Evidence of Coverage (PDF)
• 2025 Member Handbook (PDF)
• 2024 Member Handbook (PDF)
• Member Reimbursement Medical Claim Form (PDF)
• Member Welcome Brochure (PDF)
• Personal Representative Request Form (PDF)