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Enrollment Application 2017

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 

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 Ratings are calculated each year and may change from one year to the next.