AllCare Opt-Out Request Form Login

AllCare Settlement

This page is used to log into the Opt-Out Request Form. Please enter the requested information in the fields below.

Claimant ID:*

The Notice you received will have your Claimant ID listed.

Enter your last name (if your last name contains an apostrophe, omit the apostrophe):*

This field is hidden when viewing the form

Entry Verification*

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Is Valid Entry*

Yes

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