Identification Card Request
Contra Costa Health Plan
595 Center Avenue, Suite 100
Martinez, CA 94553
To request a new I.D. Card, please use the Online Form below then Submit.
Form must be fully completed before request can be processed.
Card should be received within 2 weeks of request.
If this form was not completed by member or member's legal guardian, we will be unable to process request without member's explicit agreement.