Important information for Apple Health Enrollees
We are happy to help you make this transition so you remain with your current clinic and provider. You can also download the forms below to make the change yourself. Changes become active the month following your request, but we will continue to see you prior to that if a need arises.
You can fax the form directly to them:
Coordinated Care Fax: 1 (877) 644-4613
Molina Fax: 1 (877) 556-5873 Amerigroup Fax: 1 (866) 840-4993