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Welcome to Summit Health

Forms


Enrollment Application form

Applications are also available online - Apply today

Plan change forms

Use these forms if you would like to make changes to your existing Summit Health plan.

2024

Plan Change Form (English)

Plan Change Form (En Español)

Disenrollment forms

Use these forms if you would like to disenroll from your existing Summit Health plan.

Disenrollment Form (English)

Disenrollment Form (En Español)

Coordination of benefits (COB)

If you are covered by other medical, vision, pharmacy or dental health plan, we coordinate benefits with other insurers to help you receive the full benefit of those plans.

Coordination of benefits (COB) (English)

Coordination of benefits (COB) (En Español)

Case management form

Case management is a voluntary service for members experiencing complex conditions, catastrophic events or life altering event and need assistance in managing their situation with a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), or Behavioral Health (LCSW)specialist.

To make request case management, please call Summit Health case management at 833-460-0444. You can also email casemgmtrefer@yoursummithealth.com, fax a referral to 855-232-6904, or complete and submit our online referral form.

Case Management Referral form (English)

Case Management Referral Form (En Español)

Transition/Continuity of care

You as a new enrollee transitioning on to a new plan, or an existing member whose provider network has changed, can request transition or continuity of care. You or your treating physician can provide details on the transition or continuity of care form.

Transition of care form (English)

Transition of care form (En Español)

Privacy forms and resources

Access the PHI Authorization Form (allows Summit to disclose your health information to those whom you give us permission), Advance Directive (informs healthcare providers of your wishes for your care) and Appoint a Representative (to request authorization, file a claim, grievance, or appeal). Learn about our adherence to HIPAA privacy practices.

Visit Privacy Center

Authorizing monthly electronic payment

By completing this form, you give us permission to deduct your monthly premium from a bank account

Electronic Funds Transfer (EFT) form (English)

Electronic Funds Transfer (EFT) form (En Español)

Submitting a claim

Pharmacy claim

If you go to an out-of-network pharmacy, you can see if we are able to reimburse any of your costs by completing the pharmacy paper claim form.

Pharmacy claim form (English)

Pharmacy claim form (En Español)

Medical claim

If you need to request reimbursement for medical services, you may submit proof of payment and the itemized bill with this form.

Medical claim form (English)

Medical claim form (En Español)

Routine vision claim

If you need to request reimbursement for routine vision services (such as an eye exam and glasses) from Vision Services Plan (VSP), you may submit proof of payment and the itemized bill with this form.

VSP reimbursement form (English)

VSP reimbursement form (En Español)

Dental claim

If you need to request reimbursement for dental services, you may submit proof of payment and the itemized bill with this form.

Dental claim form (English)

Dental claim form (En Español)

Making a prescription drug coverage request

Initial coverage request (determination)

Coverage determination is a decision about whether or not a prescription drug is covered. To request coverage determination, you or your provider may do one of the following:

Appeal a denied request (redetermination)

A redetermination request is an appeal of a denied coverage determination. To request coverage redetermination, you or your provider can do one of the following:

Filing a complaint with Medicare

We work to resolve any issues you may have. You can also file a complaint directly with the Centers for Medicare & Medicaid Services (CMS) by using their online form.

Get the Medicare online complaint form

Last updated Oct. 1, 2023
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Contact us

Call 844-827-2355 (TTY users, please call 711).
Our customer service team is available from 7 a.m.– 8 p.m. (Pacific Time), seven days a week October 1 – March 31 (closed on Thanksgiving and Christmas), and weekdays April 1 – September 30. Your call will be handled by our automated phone systems outside business hour.

Get more contact details

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