We want you to have great dental health. We also want you to make the most of your dental plan. Check out these resources. You can view them here, or download and print them.
Your Member Handbook can be found on your coordinated care organization’s (CCO) website. Click on the link below to access your Member Handbook. Look at your ID card to identify your CCO.
PHI Disclosure Forms
Learn more about dental health with this helpful info.
English:
Spanish:
Russian:
Simplified Chinese:
Traditional Chinese
Vietnamese:
Somali:
Arabic:
Ukrainian:
Korean:
Dari:
Use the following to file an appeal or grievance:
Member appeal form (English)
Formulario de apelación para miembros (Spanish)
форма апелляции участника (Russian)
会员申诉表 (Simplified Chinese)
會員上訴表 (Traditional Chinese)
mẫu đơn khiếu nại thành viên (Vietnamese)
foomka racfaanka xubinta (Somali)
قسم نظم الرعاية الصحية (Arabic)
ВІДДІЛ СИСТЕМ ОХОРОНИ ЗДОРОВ'Я  (Ukrainian)
보건업무부 (Korean)
فرم درخواست تجدید نظر اعضا (Dari)
Member grievance form (English)
Formulario de quejas para miembros(Spanish)
Форма заявки участника(Russian)
会员申诉表 (Simplified Chinese)
會員申訴表 (Traditional Chinese)
Mẫu gửi thành viên (Vietnamese)
Foomka soo gudbinta xubinta (Somali)
نموذج تظلمات الأعضاء(Arabic)
форма скарги члена (Ukrainian)
회원 불만사항 양식 (Korean)
فورم شکایت عضو (Dari)
Need more info? Take a look at our FAQs.
Nondiscrimination notice (English)
Aviso de no discriminación (Spanish)
Заявление о недопустимости дискриминации (Russian)
反歧视声明 (Simplified Chinese)
反歧視通知 (Traditional Chinese)
Thông báo không phân biệt đối xử (Vietnamese)
Ogaysiiska takoor la’aanta (Somali)
إشعار عدم التمييز (Arabic)
Повідомлення про неприпустимість дискримінації (Ukrainian)
차별 금지  공지 (Korean)
اطلاعیه عدم تبعیض (Dari)
Language access statement (English)
Declaración de acceso al idioma (Spanish)
Заявление о доступе к языку (Russian)
语言访问声明 (Simplified Chinese)
繁體中文 (Traditional Chinese)
Tuyên bố truy cập ngôn ngữ (Vietnamese)
Bayaanka Helitaanka Luuqadda (Somali)
بيان الوصول إلى اللغة (Arabic)
Заява про доступ до мови (Ukrainian)
언어 접근 진술서 (Korean)
بیانیه دسترسی به زبان (Dari)
We’re here for you, and we want to help.