Member Handbooks

Your Member Handbook explains services that are available to eligible children/young adults and their families. If you would like a printed copy of this handbook, please call us at 1-855-202-0973 (TTY 711).

• Member Handbook - English
• Member Handbook - Spanish

Forms

You will need to download and install Adobe Acrobat Reader from this site  to use the pdf forms.

• Authorization for Use and Disclosure of/Consent to Release Protected Health Information (PHI) -- YOU MUST FILL OUT ALL PARTS OF THIS FORM. IF ANY PART IS LEFT BLANK IT WILL BE RETURNED TO YOU TO FIX.
  • English instructions (pdf)
  • English form (pdf)
  • Spanish instructions (pdf)
  • Spanish form (pdf)
• Magellan Complaint (Grievance) Form
  • Online form
  • English form (pdf)
  • Spanish form (pdf)
• Magellan Appeal Form
  • English form (pdf)
  • Spanish form (pdf)
• Idaho Department of Health and Welfare Appeal/State Fair Hearing Form
  • English form (pdf)
  • Spanish form (pdf)
• Intensive Care Coordination Referral Form
  • English form (pdf)
  • Spanish form (pdf)
• Residential Treatment and Psychiatric Residential Treatment Form

Member Request for Access to Protected Health Information

Members have a right to access their Protected Health Information (PHI) maintained by Magellan Health, Inc. 
Please fill out the below form and submit your records request to either of the following: 

• Form: Member Request for Access to Protected Health Information (PHI) (pdf)
• Email: IBHPRecordsRequest@MagellanHealth.com
• Fax: 888-656-2585