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Appointment of Representative Form Español
Appointment of Representative form in Spanish.
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(1.3mb)
Prescription Drug Claim Form – VillageHealth (Spanish)
Se ofrece el formulario de reclamación para medicamentosrecetados como una herramienta para ayudarle a que se paguesu reclamación lo antes posible.
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(174.7kb)
2024 VillageHealth Enrollment Form - Spanish
Use this form to begin enrolling in VillageHealth (HMO-POS C-SNP) plans.
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(152.5kb)
2024 SCAN Desert Health Plan Enrollment Form - Spanish
Use this form to begin enrolling in SCAN Desert Health Plan Medicare Advantage plans.