MLTSS Materials

We are here to help you understand your benefits. Click on the links below for more information. You’ll need to have Adobe Reader to see these files. Download Adobe Reader for free here.

Please note, these materials and resources are effective January 1, 2018.

NextLevel Health MLTSS Handbook-ENGLISH 2018

NextLevel Health MLTSS Handbook-ENGLISH 2018 (Black & White)

NextLevel Health MLTSS Handbook-SPANISH 2018

NextLevel Health MLTSS Handbook-SPANISH 2018 (Black & White)

NextLevel Health MLTSS ID Card

NextLevel Health MLTSS Certificate of Coverage – ENGLISH

NextLevel Health MLTSS Certificate of Coverage – ENGLISH (Black & White)

NextLevel Health MLTSS Certificate of Coverage – SPANISH

NextLevel Health MLTSS Certificate of Coverage – SPANISH (Black & White)

Additional Materials & Resources

NextLevel Health Pharmacy Prior Authorization Form


NextLevel Health Drug Formulary

NextLevel Health Authorized Representative Form for Grievances & Appeals

NextLevel Health CI Intake Form