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

English Español

Disenrolling from Bright Health

Multi-language interpreter services


National Coverage Determination (NCD) Information

English Español 中文

Notice of nondiscrimination

English Español 中文

Medicare reimbursement claim form



Comprehensive Formulary

List of Formularies

Coverage determination request form


Extra financial help for prescription drugs

Mail order summary


Mail order form

English Español

Medication Therapy Management program

Prescription drug transition policy

Quality assurance and utilization management

Part D coverage determinations, appeals, and grievances

Redetermination of prescription drug denial request form


Reimbursement claim form


Part B Step Therapy Drug List


Safe use of opioid pain medication – information for Medicare Part D patients


Website Last Updated: Oct 15 2021