Skip navigation
SIGN IN
For Members
For Providers
Looking for a plan?
What is Medicaid?
English
Español
I NEED HELP WITH
12 Tips About Medicaid
Care Management
Coverage and Benefits
COVID-19
Disease Management
Enroll in Medicaid or Nevada Check Up
Flu Shot Locations
Health Care Terms
Health Education and Wellness
Health Plan Forms
Health Plan ID Card
Health Survey Form
Healthy Recipes
Medicaid/Check Up Member Handbook
(PDF)
Member News
Member Perks
Member Survey
MyHPN Mobile App
No-Cost Extra Benefits
Northern Nevada Community Resources
(PDF)
Online Member Center
Pharmacy/Prescription Coverage
Plan Information
Pregnancy Through Childhood
Renew Your Plan
Southern Nevada Community Resources
(PDF)
State Medicaid ID Card
State Member Survey
Update Doctor/PCP
Update Personal Information
Wellness Classes
What is Medicaid?
Where to Go For Care
DRUG LISTS
Drug List
(PDF)
Machine Readable PDL
Searchable Drug List
90-Day Prescription Supply
Care Options
24/7 Advice Nurse
24/7 NowClinic® Virtual Visits
Dental
Doctor or Provider
Pharmacy
Hospitals (Northern Nevada)
Hospitals (Southern Nevada)
Mental Health & Substance Use Benefits
Mobile Medical Center
Urgent Care House Calls
Urgent Care (Northern Nevada)
Urgent Care (Southern Nevada)
Vision
Where to Go For Care
FIND A DOCTOR
For Members
For Providers
Looking for a plan?
What is Medicaid?
SIGN IN
Health Plan Forms
Download the health plan form you need.
Appointment of an Authorized Representative Form
Authorization for the Release of Protected Health Information Form
Appeals Form
Coordination of Benefits Form
Medical Necessity Request Form
Pharmacy Reimbursement Claim Form
Primary Care Physician Change Request Form
Substance Abuse Records Release Form