Forms and Downloads
The following forms have been made available to MiCare Plan members, and those who are interested in enrolling in the MiCare Plan.
- MiCare Enrollment Form
- MiCare Amendment Form
- MiCare Plan Conversion Form
- MiCare Plan Allotment Form
- MiCare Plan Reimbursement Request Form
- MiCare Plan Required Documents for Reimbursement Claims
- MiCare Plan Request for Supplemental Authorization
- MiCare Plan Straub Patient Information Registration Form
- MiCare Brochure 2018