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Enrollment Application 

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 Miami-Dade

Application Instructions Miami-Dade

Plan Recap Miami-Dade

Broward County

Medica HealthCare Plans MedicareMax (HMO)

Enrollment Application Broward

Application Instructions Broward

Plan Recap Broward

Miami-Dade and Broward Counties

Medica HealthCare Plans MedicareMax Plus (HMO D-SNP)

Enrollment Application Miami-Dade/Broward

Application Instructions Miami-Dade/Broward

Plan Recap Miami-Dade/Broward

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 Plus MedicareMax (HMO) Miami-Dade            1-844-723-6471

Medica HealthCare Plus MedicareMax (HMO) Broward                 (TTY 711) Toll - Free

  

Medica HealthCare Plus MedicareMax Plus (HMO D-SNP)

1-866-367-7525
(TTY 711)
Toll - Free

Hours

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

Fax

1-888-950-1170

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. Limitations, co-payments, and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year. Every year, Medicare evaluates plans based on a 5‐star rating system. Star rating is for 2020.