Key plan forms and resources.

Ensure your coverage gets off to a smooth start.

Please complete and return these forms promptly to help ensure the best experience when using your health plan.

Appointment of Representative
Use this form to appoint a representative to take action on your behalf for any claim, appeal, grievance, or request. This form is valid for 365 days from the date we receive it. 

Continuity of Care
If you have upcoming appointments or procedures scheduled within the first 90 days of enrollment in your new plan, fill out this form to prevent coverage gaps during your transition to Generations Advantage.

CVS/Caremark Mail-Order Prescriptions
If your plan includes Part D Prescription Drug coverage and you would like to receive your prescription by mail, please fill out the CVS Caremark Mail-Order form and mail to CVS.

Medication Prescription Payment Plan Request
Use this form to opt-in to the Medicare Part D payment plan, allowing you to spread your prescription expenses across the year.

Member Rights & Responsibilities
Outlines the rights and responsibilities of Martin’s Point Health Plan members, including access to care, privacy, informed decision-making, and complaint and appeal rights.

Permission to Speak with Others
To let us discuss your health care with family or others, please complete and return this form. You may include any power of attorney documentation with this form.

Premium Payment Set Up
Set up secure automatic payments for your Generations Advantage premium. Choose from Social Security deductions, bank account debits, or credit card payments.

Primary Care Provider Selection
To update or change your primary care provider (PCP), please fill out and return this form. You may also make these updates in the member portal.

VA Health Coverage
If you also receive health benefits through the Veterans Administration, please fill out, sign, and return this form. 

Explore our most commonly used resources when getting started on your plan.