MEDICARE MEMBERS: PROTECT YOURSELF AGAINST MEDICARE FRAUD AND IDENTIFY THEFT! THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF INSPECTOR GENERAL IS ALERTING THE PUBLIC ABOUT A FRAUD SCHEME INVOLVING GENETIC TESTING. LEARN HOW TO PROTECT YOURSELF.
Otros formularios para afiliados | Health Net Medicare Advantage for Oregon and Washington
Formularios adicionales
Use this form when you want to allow us to share your health information with a person or group:
Use this form when you want us to cancel or revoke your previous permission to share health information with a person or group:
- PHI Authorization Form (PDF) - last updated Jul 26, 2022
- PHI Revocation Form (PDF) - last updated Oct 10, 2018
Use este formulario para nombrar a una persona para que actúe como su representante. Usted lo debe completar y la persona que usted nombre lo debe aceptar.
If you have questions please, contact Member Services.
Si tiene alguna pregunta, contacte a Servicios para Afiliados.