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Forms

3 dots utilized as bulletsAppointed Representative Instructions
3 dots utilized as bulletsAppointed Representative Form
3 dots used as bullet, design purposes onlyCoverage determination form - for enrollees
3 dots used as bullet, design purposes onlyCoverage determination form - for providers
3 dots used as bullet, design purposes onlyEnrollment form
3 dots utilized as bulletsEnrollment instructions

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To be available soon:

3 dots used as bullet, design purposes onlyMember grievance form


 

3 dots utilized as bulletsCurrent Members Contact us at 1-866-472-3691, TTY 1-800-735-2929

3 dots utilized as bulletsIf interested in joining please contact us about Healthy Generations:

Call 1-888-355-5557,  seven days a week,
8:00 a.m. - 8:00 p.m. Pacific Time,
(TTY/TDD 1-800-735-2929)


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For more information about Medicare, please call Medicare at 1-800-MEDICARE
(1-800-633-4227).

Providers: if you have questions on the status of an appeal, determination or other process, please call 1-800-788-2942.

Members: if you have questions on the status of an appeal, determination or other process, please call 1-800-260-2055 (TTY/TDD 1-800-735-2929)

TTY users should call 1-877-486-2048. You can call 24 hours a day, 7 days a week. Or, visit www.medicare.gov on the web.

If you have special needs, Healthy Generations materials may be available in other formats.

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Santa Clara Family Health Plan 2008
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Link to the SCFHP home page Link to the Healthy Generations main page