Important Documents & Forms
Member Handbook
If you would like to request a paper copy, contact UPHP Customer Service at 1-800-835-2556 (TTY: 711) and we will mail you a paper copy at no charge.
- 2025 UPHP Member Handbook: A Guide to Your UPHP Benefits
- 2024 UPHP Member Handbook: A Guide to Your UPHP Benefits
- Medicaid Certificate of Coverage
- Healthy Michigan Plan Certificate of Coverage
Forms
- Confidential Communications Member Request Form
- Request a Restriction Member Form
- Release of Protected Health Information
- Online Notification of Pregnancy Form
- UPHP Management Committee Application
- Nonopioid Directive Form – The Michigan Department of Health and Human Services has developed a nonopioid directive form. This form lets patients inform their health care providers that they do not want to receive opioids. The form can be revoked at any time by telling the provider. Individuals (or legal guardians) who want to inform a health care provider of their wish may download and complete the form and give a copy to all their health care providers, including dentists.
Member Newsletters
UPHP Medicaid members are mailed hard copy newsletters every June and December. Review past editions below for information on health, wellness, UPHP benefits, and more!
Page Last Updated: 06/10/2025