Skip to main content
For Members
For Providers
Looking for a plan?
What is Medicaid?
Renew Your Medicaid Plan
English
English
Español (Spanish)
I Need Help With
12 Tips About Medicaid
Care Management
Clinical Guidelines
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
HPN & SHL Mobile App
Important Information About Blood Pressure
Medicaid/Check Up Member Handbook
Member Advisory Council
Member News
Member Perks
Member Survey
No-Cost Extra Benefits
Northern Nevada Community Resources
Online Member Center
Pharmacy/Prescription Coverage
Plan Information
Pregnancy Through Childhood
Renew Your Plan
Southern Nevada Community Resources (PDF)
Update Doctor/PCP
Update Personal Information
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
Mental Health & Substance Use Benefits
Mobile Medical Center
Urgent Care House Calls
Urgent Care Locations
Vision
Where to Go For Care
Find a Doctor
Sign in
More Sites
Sign in
×
More Sites
For Members
For Providers
Looking for a plan?
What is Medicaid?
Renew Your Medicaid Plan
Search
Site Search
×
Menu
Home
×
I Need Help With
12 Tips About Medicaid
Care Management
Clinical Guidelines
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
HPN & SHL Mobile App
Important Information About Blood Pressure
Medicaid/Check Up Member Handbook
Member Advisory Council
Member News
Member Perks
Member Survey
No-Cost Extra Benefits
Northern Nevada Community Resources
Online Member Center
Pharmacy/Prescription Coverage
Plan Information
Pregnancy Through Childhood
Renew Your Plan
Southern Nevada Community Resources (PDF)
Update Doctor/PCP
Update Personal Information
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
Mental Health & Substance Use Benefits
Mobile Medical Center
Urgent Care House Calls
Urgent Care Locations
Vision
Where to Go For Care
Change site language
English
Back
×
Change site language
English
Español (Spanish)
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
Primary Care Physician Change Request Form
Substance Abuse Records Release Form