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  • Practitioner Termination Request - Yourcare Health Plan

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Practitioner Termination Request To terminate from a practice or the YourCare Health Plan, please complete all information as it applies. Date of request: Requested Effective Date: Type of Termination:.

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If you are assigned to a PCP and want to change, callL.A. Care Member Services at 1-888-839-9909 (TTY: 711). The change happens the first day of the next month.

Remember – while you can usually cancel your health insurance anytime, you can't usually enroll anytime: only during annual open enrollment or a special enrollment period. Before canceling your health insurance plan, make sure you've thought through what you'll do if you need medical care – and how you'll pay for it.

Please call toll-free at 1-800-777-1840, Monday through Friday, 8 a.m. to 5 p.m. local time. You can also send us an email. Simply fill out the form below and we'll be in touch.

Your insurance company can cancel your coverage if you fail to pay your premiums on time. Your insurance company notify you at least 30 days before they can cancel your coverage, giving you time to appeal the decision or find new coverage.

1. Log into your Nevada Health Link account and click My Enrollments in the left-hand navigation. 2. Scroll down to the appropriate plan and click Cancel Coverage.

To change your medical plan, call Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077). Or you can complete a Medi-Cal Choice Form. You can find the form on the Download forms page. Mail the completed choice form.

Please call toll-free at 1-800-777-1840, Monday through Friday, 8 a.m. to 5 p.m. local time. You can also send us an email.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232