| Election to Participate Form |
| Election to Participate Form - Large Print |
| Election to Participate Form - Korean version |
| Election to Participate Form - Spanish version |
| Revocation of Election to Participate |
| Revocation of Election to Participate - Spanish version |
| Revocation of Election to Participate - Korean version |
Due to a planned data migration beginning Friday, July 11 at 11:00 p.m., and continuing through Monday, July 14 at 8:00 a.m., you may experience a delay in your information appearing on CareFirst portals. We expect that changes to member data will be reflected on the portals by Tuesday, July 15. Your patience is appreciated.
Change Healthcare notifying individuals of data breach. Learn more here.
Patient-Centered Medical Home (PCMH) Forms
Patient-Centered Medical Home (PCMH)