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How to Enroll

What Happens after Enrollment?

After we receive your completed and signed individual enrollment form or online application, we will send it to the Centers for Medicare & Medicaid services (CMS) for approval.

Acknowledgement of Receipt of Application

Within 10 business days, you will receive a letter by postal mail acknowledging receipt of your completed enrollment form. This "Acknowledgement of Receipt Enrollment" letter can be used as proof of health insurance coverage before you receive your ID card in the mail.

Official Insurance Coverage ID Card and Welcome Kit

You will receive your new ID card within 10 calendar days after we receive your completed enrollment form. It is important to carry this card with you when you use your benefits. You will also receive a Welcome Kit that will include your printed Evidence of Coverage which explains all of your plan benefits and how to use your benefits.

Incomplete Applications

Within 3 business days of receipt of your application. we will contact you by postal mail if we require additional information to complete your application. This information could include verification of your eligibility based on your Medicare and/or Medicaid card number and your dates of entitlement to Medicare Part A and pre-enrollment in Part B. If you do not submit this information to us by mail or fax along with your enrollment form, we will call you to complete your application by phone.

Note: If you completed your application but used an invalid "Effective Date of Coverage" we will contact you and explain what effective dates you are eligible for. If you do not wish to begin your coverage on an officially-valid effective date, you may cancel your enrollment request. Please contact us for more information.

Ineligible Enrollments

If it is determined that you are not eligible for the health plan, a letter will be mailed to you within 10 calendar days.

Last Updated: January 1, 2012


Y0007_MKT602 (H0320) CMS Approved (10/07/2011)