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Here are the forms you’ll need to do business with NHP

Prescription Drug Reimbursement Form

If you have paid for a covered prescription from a pharmacy who does not participate with NHP, use the Prescription Drug Reimbursement Form to file a claim for reimbursement.

MassHealth Yearly Eligibility Review From

If you are an NHP member on MassHealth, you must fill out this form every year to keep your benefits. If you need help filling out the form, bring it to your health center or call MassHealth at 1-800-841-2900.

Member Reimbursement Claim Form

If you have paid for a covered service from provider who does not participate with NHP, use this form to file a claim for reimbursement.

Bike Helmet Reimbursement Form

When you buy safety helmets for toddlers, children and adults, NHP will reimburse 50% of the purchase price of one new helmet, per member, per calendar year up to a $15.00 reimbursement.

Fitness Reimbursement Form

Get fit, get paid. Our Fitness benefit will reimburse members in qualifying NHP plans up to $150 per year toward their fitness program memberships at qualifying health clubs. And under some NHP plans, another $150 in fitness program reimbursement is available for covered family members. To qualify, you must belong to a health club and have been a NHP member for a full four months in a calendar year.