UniCare Massachusetts is now Wellpoint, effective July 1, 2024. New name, same commitment to you.

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Provider forms and documents

View and download provider materials


Browse commonly requested forms and documents.

Provider reference / notification requirements

The Provider Reference Sheet lists member copay amounts and the notification requirements for services and procedures that require preapproval review.

HCAS Provider Enrollment Form

Submit the Healthcare Administrative Solutions (HCAS) Provider Enrollment Form to enroll as a Wellpoint contracted provider. If you are enrolling a group, complete a separate form for each provider who is enrolling.

Provider Information Change Form

If you are currently a Wellpoint contracted provider, use the Provider Information Change Form to notify Wellpoint of changes to your practice such as new providers in your group.

Wellpoint member ID cards

Wellpoint member ID cards show copay amounts and other plan information.


 Total Choice




 Community Choice


 Medicare Extension