Please submit correct information as it appears on your Health Card.
You
can
only request
a replacement card for yourself, your spouse (if on the
same
health card), a child under
18 (if you are the parent or guardian) or if you
have
Power
of Attorney for the
cardholder.
Submit only one Replacement Card request per Health card. This request will apply to each family member listed on the health card.
This form to replace your Manitoba Health card. If you require additional changes other than this request you will need to complete the appropriate form.
If multiple different forms must be completed simultaneously to make all appropriate changes to your Manitoba Health card, please email our office at
insuredben@gov.mb.ca with all form confirmation numbers so that we may process all
requests at the same time.