Enrollment Checklist | Alight Retiree Health Solutions

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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 are an authorized representative enrolling someone else in a Medicare plan, you'll need the information listed below for the beneficiary.

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
Social Security Number

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
Social security 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:

My Account

Review Coverage

Find a Dental Plan

Find a Vision Plan

Let’s Get Started

Ready to enroll?

Enrollment Checklist

Save a copy of your checklist

Next steps

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