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My Care Alabama East

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  • My Care Alabama East Medical Management Meeting Schedule Q1to Q4 Yr 2022 2023 application/pdf (187 KB)
  • Specialist Referral East (Please read the information on My Care East Specialist Referral page before completing this form) application/pdf (975 KB)
  • My Care Provider Referral Form East application/pdf (1 MB)
  • My Care Alabama East PCP Agreement Out of State application/pdf (161 KB)
  • My Care Alabama East PCP Agreement application/pdf (384 KB)
  • My Care Alabama East DHCP Out of State application/pdf (190 KB)
  • My Care Alabama East DHCP Non-Delivery Agreement application/pdf (195 KB)
  • My Care Alabama East DHCP Delivery Agreement application/pdf (377 KB)
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Notices

You have the right to see any Primary Care doctor no matter where the doctor is located. You have the right to pick any Alabama Medicaid doctor to deliver your baby no matter where the doctor is located. You have the right to pick any Alabama Medicaid doctor or clinic for birth control services. You do not have to use your personal primary doctor for birth control or family planning services. You do not need approval or a referral from your personal primary care doctor to get birth control or family planning services. Care Coordination services are provided in the county where you live.

My Care Alabama Central, My Care Alabama East, and My Care Alabama Northwest complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

Auxiliary aids and services are available upon request free of charge. Toll Free: 1-800-874-9426 and TTY: 711

Language interpretation and translation services are available upon request free of charge. Toll Free: 1-800-874-9426 and TTY: 711

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