Health Equity Advocacy Council (HEAC) Registration Information

* Required fields

* First name:

* Last name:

* Email:

* Phone number:

* Home ZIP code:

* Age:

* Member ID (can be found on your AmeriHealth member ID card):

* Health plan (can be found on your AmeriHealth member ID card):

* Will you be able to attend meetings in person at 259 Prospect Plains Road, Bldg M, Cranbury, NJ 08512?

Yes

* Do you require any accommodations to make attending meetings accessible for you?

Yes

If yes, please elaborate:

Please tell us something about you that will help us understand your interest in the HEAC.

By providing my phone number and/ or email address, I authorize AmeriHealth to contact me via email, automated text and/or phone call. I understand that my consent is not a condition of any benefit or purchase and that I can opt out at any time. Message and data rates may apply.

For accommodations of persons with special needs at meetings, call 1-877-393-6733 (TTY/TDD: 711).

AmeriHealth offers PPO Medicare Advantage plans with a Medicare contract. Enrollment in AmeriHealth PPO Medicare Advantage plans depends on contract renewal.

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Website last updated: 3/25/2024