Policies & Forms

Member Handbook

You can submit this form if you would like to designate an authorized representative to act on your behalf.

For Parents & Guardians of Children Ages 0 to 10 Years Old

For Parents & Guardians of Children Ages 11 to 17 Years Old

For Adults 18 and Older

Has your provider or care manager talked with you about MassHealth’s Community Partners program? These services are provided to you at no cost. Bring this form to your provider to fill out.

It is the policy of RHG Medicaid Network, LLC, and its parent organization, Revere Medical, to implement an effective system to address concerns related to members’ care and experience. To read the complete policy, download the PDF provided.