Get Magellan Health Embrace Emergency Assistance Program Application 2018-2025

The Magellan Health EMbrace Emergency Assistance Program Application is designed to assist employees who are facing financial hardships due to life events. This guide provides a clear, step-by-step approach to help you complete the application effectively and efficiently.

Follow the steps to successfully complete your application online.

1. Press the ‘Get Form’ button to acquire the application form and open it in your online document editor.
2. Begin by filling out Section 1 with your personal information, ensuring to print your name clearly at the top of each page. Provide your permanent home address, contact numbers, preferred method of contact, and employment details.
3. Move to Section 2 to describe your situation. Indicate the type of qualifying incident that caused your financial hardship and provide further details, including the date of the incident and whether insurance has covered it.
4. In Section 3, specify your request for financial assistance by listing the vendors you need help with, ensuring to detail the nature of the bills and the associated amounts. Attach any required documentation, such as invoices or compliance forms.
5. Complete Section 4, understanding the essential program information, and affix your signature and date. This certifies the truth of your application and its contents.
6. Before submitting, review the Application Checklist to confirm all requirements are met, including enclosing necessary documentation and signing the application.
7. Once completed, save your changes, and you may download, print, or send the application via email or mail to the designated address provided.

Take action today and complete your application online to access the support you deserve.