Forms

At Saint Mary’s Health Plans, our goal is to make our health plans easy to understand and our coverage easy to access. We strive to be responsive to each member's needs and we are committed to helping you get all you need from your health plan quickly, efficiently and conveniently. Below are links to a variety of downloadable forms needed to access your health care:

• Member Claim Form (PDF)
• Disclosure of Health Information Form (English) (PDF)
• Disclosure of Health Information Form (Spanish) (PDF)
• Dependent Disability Verification (PDF)
• Transition of Care Form (PDF)
  
  
• Catamaran (formerly Catalyst) Mail-Order Form (PDF)
• Catamaran (formerly Catalyst) Mail Health, Allergy & Medication Questionnaire (PDF)
• Catamaran (formerly Catalyst) Member Reimbursement Form (PDF)
  
• Travel Reimbursement Form (PDF) for authorized specialty care at an SMHP-designated Center of Excellence facility
  
  
• Glossary of Health Coverage and Medical Terms - The Patient Protection and Affordable Care Act requires health insurance companies to provide their members with concise documents detailing information about health plan benefits and coverage, including a Glossary of Health Coverage and Medical Terms. This glossary has many commonly used terms, but isn’t a complete list and may be different from the terms and definitions as defined by the plan documents provided by Saint Mary’s Health Plans. Please refer to your Summary of Benefits and Coverage for information about how to get a copy of your policy or plan document.