Let’s Get Started

Ready to enroll?

Before you begin, you’ll save time if you gather everything you’ll need to refer to during the enrollment process. This includes documents, personal information, and medical information. If you’re buying health coverage on behalf of a dependent, such as a child or spouse, you’ll need the same information for each dependent.

You can always save your work and return to it later, print the checklist, or download it as a PDF.

Read when you can join, change, or end a plan on our Election Period page.

Enrollment Checklist

Personal Information

  • Name
  • Date of Birth
  • Primary Address
  • Including county
  • Mailing Address
  • If different
  • Phone Numbers
  • Email Address
  •  

Health Care Information

  • Medicare insurance information
  • Medicaid number
  • If enrolled in a State Medicaid program and enrolling into a Dual-SNP
  • Other medical insurance or prescription drug plan information
  • If applicable
  • Long-term care facility information
  • If applicable
  • Preferred primary care doctor
  • Preferred specialist(s)
  • Preferred hospital(s)
  • Current prescriptions
  • Name, Dosage and Frequency

Documents

  • Medicare Card
  • Previous insurance card
  • Banking information
  • Account number and ABA routing number
Save a copy of your checklist

Download a PDF of this enrollment checklist

Print a copy of this enrollment checklist

Next steps

Learn how to get complete coverage and more:

We're here to help

Talk with an expert:

1-800-350-1470 (TTY 711)
Monday - Friday 8 a.m. – 8 p.m. Central Time
 
 
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