HIPAA and Privacy Forms

The Health Insurance Portability and Accountability Act (HIPAA) ensures your access to various health and human services, and it protects the privacy and security of your medical records and information. As a health plan, CountyCare regularly communicates with your provider about your care, and we follow strict guidelines outlined by HIPAA.

These forms can help you:

Download the forms above to make a request regarding your medical records. Questions? Call us at 312-864-8200 / 711 TTD/TTY.

CountyCare’s member services phone line is experiencing an outage.

If you are seeking behavioral health services, please call 1-800-345-9049. If you are experiencing a behavioral health crisis, please call 911. We are working to resolve this as soon as possible. Thank you for your patience.