Member Forms & Resources Information

Below are the most commonly used member forms and other related resources.

HIPAA Authorization of PHI Release

This form is used to release your protected health information as required by federal and state privacy laws. Your authorization allows the Health Plan to release your protected health information to a person or organization that you choose.

Member Portal Reference Guide

Logging on to gives you direct, 24/7 access to your personal claims and account history, benefit and expense limits, plan documents and forms, locate a provider and other support tools.

Transition of Care Form

Transition of Care coverage allows you to continue to receive services for specified medical and behavioral conditions for a defined period of time with health care professionals who do not participate in the FirstCare Health Plans network until the safe transfer of care to a participating doctor or facility can be arranged.

Provider Nomination

Provider Nomination allows you to nominate a physician to participate in HMA Advanta provider network.