Member materials and forms

Here, you’ll find the info and forms you need to get the most out of your plan.

Member materials

Need your member handbook?

You can download your member handbook from this page. Or you can get a hard copy at no charge. We’ll send it to you within five business days of your request. Just call 1-888-348-2922 (TTY: 711). Or complete this member handbook request form.

Mountain Health Trust - Medicaid and CHIP handbook (PDF)

Mountain Health Promise handbook (PDF)

Aetna Better Health of West Virginia Community Report (PDF)

You can also get a copy of the Aetna Better Health of West Virginia Annual Report. Need a copy? Call Member Services at 1-888-348-2922 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.

Forms

Authorization to release protected health information (PHI) (PDF)

Authorization to release psychotherapy notes (PDF)

Protected health information access request (PDF)

Fraud, waste and abuse form

Member Advisory Committee (MAC) form

Freedom of Choice form (PDF)

FamilyCare Central ROI Form (PDF)