Your username will only be remembered on this device. For your security, only the first and last digits will be shown. Only the most recently "remembered" username will be saved.
Also known as User ID
Enter your ZIP code to learn about the CarePlus Medicare Advantage plans in your area, or call us at 1-855-605-6171; TTY: 711.
CarePlus has worked diligently to comply with privacy provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), a federal law designed to ensure the privacy of personal and health information. In addition to all federal laws, CarePlus also complies with all state laws and regulations.
Review the documents to get a thorough understanding of how CarePlus uses and discloses personal health information.
The following is a brief description of the various HIPAA individual rights and the appropriate form to invoke one of these rights.
Consent for Release of Protected Health Information
This form grants CarePlus permission to share your information to a trusted individual(s) that you choose. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
Revocation of Consent for Release of Protected Health Information
This form terminates previously granted permission for CarePlus to release or disclose a member's protected health information to other individuals named on the form. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
Request for Accounting of Disclosures
This form requests a list of disclosures CarePlus made of a member's protected health information. Disclosures made for payment and health plan operations are excluded from this process. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
Request for Amendment of Protected Health Information (PHI)
This form requests a correction to CarePlus-created protected health information that a member feels is inaccurate or incomplete. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
Request to Access Protected Health Information
This form requests an inspection or copy of CarePlus-maintained protected health information about a member. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
Request for Restriction of Protected Health Information
This form requests limitation or restriction of disclosures of a member's protected health information to others such as a family member, friend, spouse, doctor, or any other party. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
Request for Restriction Termination
This form withdraws a previously requested restriction of a member's protected health information. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
Request for Alternate Communications
This form requests that CarePlus communicate with a member about protected health information in a different way during life-threatening situations. Examples of alternate means could include telephone, mail, e-mail, or different address. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
Privacy Complaint Form
This form documents an issue or concern if a member believes his or her privacy rights may have been violated. This form was last updated in July 2019.
PDFEnglish (link opens in new window) | PDFSpanish (link opens in new window)
