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1-800-407-9069 (TTY - 711) Toll-Free
8 a.m. - 8 p.m. local time, 7 days a week

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Enrollment Application 2021

You can enroll in a Medica HealthCare plan RIGHT NOW by doing the following:

1. Download, print and complete form with signature:

Miami-Dade County

Medica HealthCare Plans MedicareMax (HMO)

Enrollment Application

Application Instructions

Plan Recap

Broward County

Medica HealthCare Plans MedicareMax (HMO)

Enrollment Application

Application Instructions

Plan Recap

Miami-Dade and Broward Counties

Medica HealthCare Plans MedicareMax Plus (HMO D-SNP)

Enrollment Application

Application Instructions

Plan Recap

Need Assistance Completing This Form?

	Medica HealthCare Plus MedicareMax (HMO) Miami-Dade 1-844-723-6471 Medica HealthCare Plus MedicareMax (HMO) Broward (TTY 711) Toll - Free
	1-888-950-1170
	Medica HealthCare Plus MedicareMax Plus (HMO D-SNP) 1-866-367-7525 (TTY 711) Toll - Free
	1-888-950-1169
	Open 8 a.m. a 8 p.m 7 days a week, including holidays

OR:

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

By clicking here you are leaving the Medica HealthCare Plans Website

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.