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Managed Health Services Indiana (MHS Indiana) fax number

(866) 912-1629

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Member Services

Used for: Submission of member-related forms and communications; commonly used for disenrollment requests and other member-service communications.

Fax destination details

Department
Member Services
Purpose
Submission of member-related forms and communications; commonly used for disenrollment requests and other member-service communications.
Form
Disenrollment form — Request for Member Disenrollment Form
Address
1099 N. Meridian Street, Suite 400, Indianapolis, IN 46204
Voice phone
1-877-647-4848

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
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Fax the completed disenrollment form to MHS Member Services at 1-866-912-1629.

Official form instructions are published as a downloadable file on the organization's website.

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