Member Materials & Forms
Below you will find the materials and forms you will need as a member of SelectHealth.
You can get a printed copy of SelectHealth Member Materials by calling the SelectHealth Care Team at 1-866-469-7774 (TTY: 711), 8 am – 6 pm, Monday – Friday.
Applied Behavioral Analysis (ABA) Services - English
DownloadApplied Behavioral Analysis (ABA) Services - Spanish
DownloadArticle 29-I Voluntary Foster Care Agency (VFCA) Health Facility Services - English
DownloadArticle 29-I Voluntary Foster Care Agency (VFCA) Health Facility Services - Spanish
DownloadPT, OT, ST Service Limits - English
DownloadPT, OT, ST Service Limits - Spanish
DownloadChildren and Family Treatment and Support Services (CFTSS) - English
DownloadChildren and Family Treatment and Support Services (CFTSS) - Spanish
DownloadCrisis Residence Services for Children and Adults - English
DownloadCrisis Residence Services for Children and Adults - Spanish
DownloadMaximum Copay - English
DownloadMaximum Copay - Spanish
DownloadDiabetes Prevention Program Services - English
DownloadDiabetes Prevention Program Services - Spanish
DownloadClick this link to search for the most up to date Provider or Pharmacy near you.
Or download and search by borough below.