If you need help completing the form, please call Customer Service at:

Call toll-free 1-866-593-4468
TTY toll-free 711
8 a.m. – 8 p.m. CST, 7 days a week

By Fax

Print an enrollment form. After you have completed it, review it for accuracy, sign, and fax it to 615-291-9561.

If you need help completing the form, please call Customer Service at:

Call toll-free 1-866-593-4468
TTY toll-free 711
8 a.m. – 8 p.m. CST, 7 days a week

By Internet

Medicare beneficiaries may enroll in HealthSpring through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

For more information, please contact HealthSpring Customer Service at:

Call toll-free 1-866-593-4468
TTY toll-free 711
8 a.m. – 8 p.m. CST, 7 days a week

When can I enroll?

Annual Enrollment Period (AEP)

The Annual Enrollment Period is from October 15 until December 7 of each year and is when a Medicare beneficiary can enroll into a Medicare Part D plan or re-enroll into their existing Medicare Part D Plan or change into another Medicare Part D plan. Beneficiaries can also switch to a Medicare Advantage Plan that also has a Prescription Drug Plan. The chosen Medicare Part D plan coverage begins January 1st.

A Medicare beneficiary cannot enroll into or drop Medicare Part D, the prescription drug benefit during the Open Enrollment Period. If a beneficiary has started the year with Part D, they must keep it for the remainder of the calendar year.

Special Enrollment Period (SEP)

Beneficiaries who qualify for "extra help"/ Low Income Subsidy (LIS) can change plans in any month of the year if they wish. This is known as the Special Enrollment Period.

Am I eligible to join?

You can join this plan if you are entitled to Medicare Part A & enrolled in Medicare Part B & live in our service area. Some plans have additional enrollment criteria to that are specific to that plan – you can speak to one of our Sales Representatives to clarify what the criteria are or use our website’s enrollment tool by clicking here to get these criteria for the plan you are interested in. The Annual Enrollment Period is from October 15 to December 7, each year.

Medicare Prescription Drug Benefit is only available to members of the MA-PD plan.

If a beneficiary is already enrolled in a MA-PD plan, the enrollee must receive their Medicare Prescription Drug Benefit through this plan.

Making changes to your coverage after December 31

Between January 1– February 14, 2011, if you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare. If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

During this period, you can’t do the following:

• Switch from Original Medicare to a Medicare Advantage Plan.
• Switch from one Medicare Advantage Plan to another.
• Switch from one Medicare Prescription Drug Plan to another.
• Join, switch, or drop a Medicare Medical Savings Account Plan.

In most cases, you must stay enrolled for that calendar year starting the date your coverage begins. However, in certain situations, you may be able to join, switch, or drop a Medicare Advantage Plan at other times. Some of these situations include the following:

• If you move out of your plan’s service area.
• If you qualify for Extra Help.
• If you live in an institution (like a nursing home).
  

Who can enroll when it is not Open Enrollment?

You may qualify for an exception to the limited open enrollment window. Some exceptions are:

• You are a newly eligible for Medicare, such as newly turning 65. You do not need to wait for Open Enrollment.
• You are eligible for both Medicare and Medicaid and therefore you can enroll at any time during the year.
• You are eligible and have lost your prior prescription drug coverage which met the criteria of being "creditable coverage" per the CMS guidance.
• You have entered a long term care facility

Do you qualify for extra help with your prescription drugs?

Medicare provides "extra help" to pay prescription drug costs for people who have limited income and resources. Resources include your savings and stocks, but not your home or car. If you qualify, you will get help paying for any Medicare drug plan's monthly premium, yearly deductible, and prescription co-payments. If you qualify, this extra help will count toward your out-of-pocket costs.

People with limited income and resources may qualify for extra help one of two ways. The amount of extra help you get will depend on your income and resources:

1. You automatically qualify for extra help and don't need to apply.
2. You apply and qualify for extra help.

If you are not receiving this additional assistance, you should contact 1-800-MEDICARE or click here to see if you might qualify.

Please refer to your Evidence of Coverage for additional details on "extra help"/Low Income Assistance (LIS). The following tables will show you what your monthly plan premiums would be if you get extra help.