Medicare forms and documents for Miami-Dade.
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
Automatic Premium Payment Authorization Form English Español 中文
Disenrolling from Bright Health
Multi-language interpreter services
National Coverage Determination (NCD) Information
Notice of nondiscrimination
Medicare reimbursement claim form
Authorization to Share Personal Health Information (ASPI)
Enrollment Form
Enrollment Form HMO English Español
Enrollment Form POS English Español
Enrollment Form CSNP English Español
Summary of Benefits
English H4709031 Español H4709031
English H4709035 Español H4709035
English H4709036 Español H4709036
English H4709037 Español H4709037
English H4709039 Español H4709039
English H4709040 Español H4709040
Evidence of Coverage
Annual Notice of Changes
Website Last Updated: Oct 14, 2022
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