You will need:

  • A Medicare ID Card Your Medicare ID Card
  • Insurance ID Card Any medical or prescription drug coverage plan information

To get started:

Other ways to enroll:


Print the application / Print the Spanish application Print the application / Print the Spanish application and mail it to us.

No Printer? Request an application and pre-enrollment kit to be mailed to you.


Call a Member Service Representative

1-888-377-1439 (TTY/TDD users call 711), 24 hours a day, 7 days a week.

By completing the online enrollment application, you will be sending an actual enrollment request to EnvisionInsurance Company. Medicare beneficiaries may also enroll in EnvisionInsurance through the CMS Medicare Online Enrollment Center located at View enrollment disclaimers.

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