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NPP

Enrollment Application 2019

Click here for 2018 Enrollment


Instructions and Disclaimers

Here is how you can enroll in a Medica Healthcare plan NOW:

1. Download, print and complete form with signature:

Miami-Dade County

Medica HealthCare Plans MedicareMax (HMO)

Enrollment Application

Application Instructions

Broward County

Medica HealthCare Plans MedicareMax (HMO)

Enrollment Application

Application Instructions

Miami-Dade and Broward Counties

Medica HealthCare Plans MedicareMax Plus (HMO SNP)

Enrollment Application

Application Instructions

OR:

2. Enroll online by completing and submitting your enrollment form electronically!

By clicking here you are leaving the Medica HealthCare Plans Website

Need Assistance Completing This Form?

Phone

Medica Healthcare Plans MedicareMax (HMO) Miami-Dade
Medica Healthcare Plans MedicareMax (HMO) Broward

1-844-723-6471
Toll Free

Medica HealthCare Plans MedicareMax Plus (HMO SNP)

1-866-367-7525
Toll Free

TTY users call toll-free 711

Fax

1(501) 262-7070

Hours

8 a.m. to 8 p.m
7 days a week, including holidays

Email

Enroll@Cuhcsouthflorida.com

Enrollment disclaimer information

Medica HealthCare is insured through UnitedHealthcare ®Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan's contract renewal with Medicare. This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Medicare beneficiaries may also enroll in Medica HealthCare through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Medicare has neither reviewed nor endorsed this information. Medicare evaluates plans based on a 5-Star rating system. Star Rating is for 2019.