Medicare forms and documents.

Bright HealthCare's job is not complete when you enroll in a Medicare Advantage plan. We are available to help throughout your healthcare experience. View some of our additional resources you may need while a Bright HealthCare member.

2022 forms and documents

Do you want to give a friend, family member or lawyer the right to make some decisions for you? You can give someone you trust the right to act on your behalf. Just fill out this appoint a representative form and mail to the address below. The appointment lasts up to a year unless you cancel it first.

Bright Health PO Box 853959 Richardson, TX 75085-3959

Appointing a representative

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Automatic Premium Payment Authorization Form English Español 中文

Disenrolling from Bright Health

Extra Help (LIS) summary

Multi-language interpreter services


National Coverage Determination (NCD) Information

English Español 中文

Notice of nondiscrimination

English Español 中文

Medicare reimbursement claim form



Authorization to Share Personal Health Information (ASPI)

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Website Last Updated: Oct 14, 2022