Maxicare

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How can we help?

Let us know how we can assist you

Looking for some answers?

Head on over to our
Frequently Asked Questions page

Want to talk to us?

Contact any of the numbers below to get in touch

Product Inquiry Hotline

24/7 Customer Care Email

24/7 Customer Hotline

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Downloadable Forms

Agents Accreditation Application FO-SS-010

Claims Reimbusement Form FO-CL-0.034

Customer Information Form (CIF)

Auto Credit Arrangement Authorization Form – Reimbursement Non Medical

Broker Application Form FO-SS-0 016

Member & Card Maintenance Form

Claims Reimbursement Questionnaire for
RT-PCR test
DOH-PSMID as of March 10, 2020

BestLIFE Download sample

Group Policyholder’s Statement

Group Death Claimant’s Statement

Group Death Claim Checklist
Deed of Extra Judicial Settlement with Minor

Affidavit of Parental Care & Custody

Group Employer’s Statement

Group Death Attending Physician’s Statement

Deed of Extra Judicial Settlement

Affidavit of Self Adjudication

Special Power of Attorney

Downloadable Forms

Agents Accreditation Application FO-SS-010

Claims Reimbusement Form FO-CL-0.034

Customer Information Form (CIF)

Auto Credit Arrangement Authorization Form – Reimbursement Non Medical

Broker Application Form FO-SS-0 016

Member & Card Maintenance Form

Claims Reimbursement Questionnaire for RT-PCR test

DOH-PSMID as of March 10, 2020

BestLIFE Download sample

Group Policyholder’s Statement

Group Death Claimant’s Statement

Group Death Claim Checklist
Deed of Extra Judicial Settlement with Minor

Affidavit of Parental Care & Custody

Group Employer’s Statement

Group Death Attending Physician’s Statement

Deed of Extra Judicial Settlement

Affidavit of Self Adjudication

Special Power of Attorney

Need help understanding
certain terms?

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Looking for an LOA?

A Letter of Authorization (LOA) is needed to visit all Maxicare affiliated hospitals that aren’t Primary Care Clinics

Need to get reimbursed?

We’re more than happy to help out