Member Materials and Forms
Helping you manage all the moving pieces
We’re here to make health care less complicated for you. Use these resources to help you fill out your Health Assessment, understand your benefits, file a complaint and more.
New to the Anthem HealthKeepers Plus plan?
As a new member, we know you have questions. We also know you’re short on time! Learn the basics about your health plan on the New Member Welcome page.
Health Assessment
Tell us more about your health, so we can help connect you with care and doctors that fit your needs. Fill out your Health Assessment to help us learn more about you.
Complete your Health AssessmentHandbooks and forms
Handbooks
Medallion Medicaid and FAMIS
- Medallion 4.0 Member Handbook - English
- Medallion 4.0 Member Handbook - Spanish
- RX Home Delivery Update - English
- RX Home Delivery Update - Spanish
CCC Plus
- Member Handbook - English
- Member Handbook - Spanish
- RX Home Delivery Update - English
- RX Home Delivery Update - Spanish
Forms
Grievances and appeals forms
Waivers and advance directives
Elderly or Disabled with Consumer Direction (EDCD) WaiverPrivacy Practices
Paid Sick Leave of Consumer-Directed Attendants
You can call Member Services at 800-901-0020 (TTY 711), if you’re a Medallion/FAMIS member, or at 855-323-4687 (TTY 711) if you’re a CCC Plus member, Monday through Friday from 8 a.m. to 8 p.m. Eastern time to ask for paper handbooks or forms at no charge. We’ll mail them to you within 5 business days. You can also visit anthem.com/vamedicaid to Live Chat with a representative.
