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Member Manual

CountyCare’s Member Handbook is available to help members. The Handbook helps members learn about:

  • Eligibility
  • Benefits
  • How to Pick a PCP
  • How to Get Started as a New Member
  • How to stay a CountyCare Member

Enrollee Handbook

Click here to download the Enrollee Handbook (PDF 4.65mb)

Certificate of Coverage

Click here to download the Certificate of Coverage (PDF 2.44mb)

Haga clic aqui para bajar el Certificado de Cobertura (PDF 4mb)

Long Term Service & Supports (LTSS) Program Overview

Click here to download the LTSS Overview (PDF 1.33mb)

Call Member Services if you have questions after reviewing the Handbook. You can also request the handbook in another language or in other formats.

 

Forms

Authorized Representative Form

Use this form if you would like another person to act on your behalf for an appeal or grievance.

Download Form

Authorization to Disclose Protected Health Information (PHI)

Use this form if you like to allow another person to speak to customer service on your behalf or would like to send documents to another person or group.

Download Form

Revocation Form

Use this form if you would like us to stop sharing information with another person or group.

Download Form


  

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