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Quick Reference Guide & Forms for Members | Ambetter from WellCare of New Jersey
Member Resources
Many of our member resources, such as the member handbook and forms, can be found by logging into your online member account. Click Login to create an account and access a wide array of resources!
Quick Reference Guide (QRG)
Reference Materials
- Balance Billing Disclosures
- 2022 Transparency Notice
- Women's Health and Cancer Rights Act Annual Notice
- Statement of Non-Discrimination
- COVID-19 Home Testing Kits
- Preventive Services Guide (PDF)
Forms
- Deductible Carry Over (PDF)
- Grievance and Appeals Forms (PDF)
- Member Reimbursement Medical Claim Form (PDF)
- Member Reimbursement Form - OTC Covid Test (PDF)
- Donor Transplant Travel Reimbursement Form (PDF)
- Recipient Transplant Travel Reimbursement Form (PDF)
- Authorization to Disclose Health Information Form (PDF)
- Revocation of Authorization Form (PDF)