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Medical Plan OptionsProvider ChoiceHealth Net HMO Kaiser Permanent Health Net HMO providers only; each family member may select his or her own doctor. Anthem Blue Cross Select HMO1Kaiser HMO providers
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How to fill out provider choice

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Step 1: Start by gathering all the necessary information and documents required to fill out the provider choice form.
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Step 2: Read and understand the instructions provided on the form carefully.
03
Step 3: Provide your personal details such as name, address, contact information, and any other required information.
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Step 4: Indicate the type of provider you are choosing (such as a doctor, hospital, or clinic) and the specific details of your choice.
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Step 5: If applicable, provide any additional information or preferences regarding your provider choice.
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Step 6: Double-check all the information provided on the form for accuracy and completeness.
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Step 7: Sign and date the form, and keep a copy for your records.
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Step 8: Submit the filled-out provider choice form as per the instructions provided, whether it is through mail, online submission, or in person.

Who needs provider choice?

01
Anyone who has access to various healthcare options needs provider choice.
02
Individuals who have health insurance or are part of a healthcare program that allows them to select their preferred provider.
03
Patients who require specialized care and want to choose a specific doctor, hospital, or clinic to meet their specific needs.
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People who want to have more control and involvement in their healthcare decisions.
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Those who are not satisfied with their current healthcare provider and want to explore other options.
06
Individuals who have relocated to a new area and need to find a new healthcare provider.
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Provider choice is the selection of a healthcare provider by an individual for receiving medical services.
Individuals who are eligible for healthcare coverage and benefits are required to file provider choice.
Provider choice can be filled out by completing the necessary forms provided by the healthcare insurance provider.
The purpose of provider choice is to allow individuals to choose their preferred healthcare provider based on their medical needs and preferences.
Provider choice typically requires information such as the name of the chosen provider, their contact information, and any relevant insurance or policy numbers.
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