Get the free Name Change for AmeriHealth Mercy Health Plan and
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Name Change for
AmeriHealth Mercy Health Plan
and Keystone Mercy Health Plan
Effective June 1, 2013, AmeriHealth Mercy Health Plan and Keystone Mercy Health
Plan are changing their
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How to fill out name change for amerihealth
How to fill out name change for AmeriHealth:
01
Obtain the name change form: The first step is to acquire the appropriate name change form. This can typically be found on the AmeriHealth website or by contacting their customer service. Make sure you have the latest version of the form.
02
Fill in your personal information: Begin by providing your personal details, including your current name as it appears in AmeriHealth records, your member ID, and your contact information. Be sure to double-check your information for accuracy.
03
Indicate the reason for the name change: Specify the reason for the name change, whether it is due to marriage, divorce, legal name change, or any other relevant circumstance. Provide any necessary supporting documentation as instructed on the form.
04
Provide legal documentation: If your name change is due to marriage or divorce, you will likely need to include a copy of your marriage certificate or divorce decree. Ensure that the documents are valid and properly notarized, if required.
05
Update dependent information: If you have dependents covered under your AmeriHealth plan, indicate their names and provide any necessary documentation for their name change as well. This may include birth certificates, adoption papers, or legal guardianship documents.
06
Review and submit: Take the time to review your completed form and ensure that all information is accurate and legible. Attach any required supporting documentation, as outlined in the instructions. Finally, sign and date the form before submitting it to AmeriHealth.
Who needs name change for AmeriHealth?
01
Individuals who have recently gotten married and wish to update their last name in AmeriHealth records.
02
Individuals who have gone through a divorce and would like to revert to their maiden name or change to a new name.
03
Individuals who have legally changed their name for various reasons and require the updated information to reflect in their AmeriHealth coverage.
04
Individuals who have had children and need to update their dependent's last name to align with their own or their partner's name.
05
Individuals who have experienced any other circumstance where a name change is necessary, such as a change in gender identity or religious conversion.
It is important to note that each individual's circumstance may vary, and it is recommended to consult with AmeriHealth or refer to their specific guidelines for accurate information.
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What is name change for amerihealth?
Name change for AmeriHealth is the process of updating the legal name of the entity.
Who is required to file name change for amerihealth?
The authorized representative or legal entity is required to file the name change for AmeriHealth.
How to fill out name change for amerihealth?
The name change form for AmeriHealth can be filled out online or submitted via mail with the required documentation.
What is the purpose of name change for amerihealth?
The purpose of name change for AmeriHealth is to accurately reflect the updated legal name of the entity.
What information must be reported on name change for amerihealth?
The name change form for AmeriHealth typically requires the old legal name, the new legal name, and the reason for the name change.
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