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• By Mail
• In Person
• What Happens After Enrollment?

Printable enrollment forms are available on this website. Visit our Explore Your Plan section. Select a plan in the left-hand column to view your plan information page which includes a link to open the .pdf form.

After downloading and printing the individual enrollment form, mail or fax the completed form to your local office. Our address and fax numbers are located on the contact us page.

For fastest processing time, please include a photocopy of your Medicare card (and Medicaid card, if applicable) with your signed enrollment form. Otherwise, you may receive a phone call from us in order to confirm your eligibility to enroll in our Medicare plans.

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