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

Your answers to these questions will help Revere Health Choice connect you to services available through your insurance at no cost to you.

As a Revere Health Choice member, you have Extra Benefits like our Healthy Beginnings Program. We are here to support you and your family during pregnancy, birth, and beyond.

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.