• YOUR EMPLOYEE HEALTH PLAN
• INDIVIDUAL PLAN
• MEDICARE PLANS
• SALUD! (MEDICAID)
• SCI
• ALBUQUERQUE PUBLIC SCHOOLS
• STATE OF NEW MEXICO
• FEDERAL EMPLOYEES
• IMPORTANT FORMS & RESOURCES
• PROVIDER FINDER

Important Forms and Resources

Below are important forms & resources you may need as a Lovelace Health Plan member:

• Appointment of Personal Representative Form
• Appointment of Personal Representative Form (Spanish)
• Member Submitted Claim form
• Pharmacy Refund Request
• SCI Preauthorized Payment Authorization Form
• Request for Access to Health Care Information
• Utilization Management Statement
• Medco Pharmacy Mail Order Health, Allergy & Medicine Questionnaire (HMQ)
• Medco Pharmacy Mail Order Form
• Medco Pharmacy Order Form

If you have any questions or cannot find what you are looking for, call us at 505.727.LOVE or statewide at 800.808.7363