Carrier Enrollment Submission Information
| Carrier Name **ALL APPLICATIONS MUST BE SIGNED & DATED PRIOR TO THE REQUESTED EFFECTIVE DATE** | Product Type | Fax Number/Email | Additional Notes |
|---|---|---|---|
| AARP/UHC | AARP (MEDSUPP-ONLY) | 888-836-3985 | |
| Aetna (HP) | Aetna (HP) | (888) 554-7668 | *To Verify Fax number, refer to the First two letters of the App Code (bottom right hand corner of application) |
| Aetna (MA & PD) | Aetna (MA & PD) | (866) 441-2341 | *To Verify Fax number, refer to the First two letters of the App Code (bottom right hand corner of application) |
| Aetna (NG/JV/DS/SM/MA/CB/QN) | Aetna (NG & JV) | (866) 756-5514 | *To Verify Fax number, refer to the First two letters of the App Code (bottom right hand corner of application) |
| Aetna DSNP GA (US & QS) | Aetna (US & QS) | (844) 984-0393 | *To Verify Fax number, refer to the First two letters of the App Code (bottom right hand corner of application) |
| Aetna Silver Script | (866) 552-6205 | ||
| Aetna (RX) | Aetna (RX) | (866) 415-2232 | *To Verify Fax number, refer to the First two letters of the App Code (bottom right hand corner of application) |
| Aetna Senior Supp | Aetna-Med Supp | 877-380-2777 | |
| Aetna BOR Change | BOR Change | No longer accept from an agent or an agency | Member initiated only 1. Client can call Member Services using the phone # noted on the back of their ID card 2. Submit a hand-written or signed letter to Aetna Medicare Broker Services @ 2222 Ewing Road, Moon Township PA 15108 |
| Americo | Final Expense | 800-395-9261 | |
| Anthem | HMO, DSNP, PPO | 800-833-8554 | |
| Anthem | Extras | 877-238-1107 | |
| Anthem | Med Supp | 844-236-7967 | |
| Anthem | PDP (NON CT) | 800-833-8554 | |
| Anthem | PDP (CT ONLY) | 866-342-7048 | |
| Anthem BOR Change | BOR Change | Senior_Salescomp@Anthem.com | |
| BCBSRI | ALL | MedicareEnrollmentIntake@bcbsri.org | |
| CarePartners of CT | ALL | 781-982-1887 | |
| Cigna | Med Supp | 877-704-8186 | |
| Cigna | PDP Only | 1-800-735-1469 | |
| Combined | Med Supp | 866-545-8076 | |
| Emblem Health | ALL | 866-890-7722 | |
| Envision Rx | PDP | FIRST: Key in client's name at www.envisionrx.com THEN FAX TO: 844-293-4756 | |
| Fallon Navicare SCO & Navicare SCO BOR Changes | SCO | Email to: MedicareSalesBrokers@fallonhealth.org | cc: Nicolette.Letourneau@Fallonhealth.org |
| Fallon (All Other) | All except SCO | MedicareSalesOperations@fallonhealth.org | cc: Nicolette.Letourneau@Fallonhealth.org |
| Fallon BOR Change | BOR Change | MedicareSalesOperations@fallonhealth.org | |
| Foresters | All | 866-300-3830 | |
| Gerber | All | 877-608-4634 | |
| HPHC | HPHC - Med Supp | MedicareBrokerSupport@point32health.org | |
| HPHC | HPHC - STRIDE | strideenrollment@harvardpilgrim.org | |
| Humana | All (Except DSNP) | 877-889-9936 | |
| Humana | DSNP only | 1-877-889-9923 | |
| Molina | All | 844-541-6848 | |
| Mutual of Omaha | All | 855-867-7611 | This is not United of Omaha. They are different. |
| Sentara | All | Express Enrollment Online (preferred) | Fax: 757-648-1367 (backup) Email: medicare@sentara.com (backup) |
| Settlers | All | 888-275-2644 | |
| SilverScript | PDP | FIRST: Submit enrollment to www.silverscriptagentportal.com THEN FAX TO: 866-552-6205 or EMAIL TO: Enrollment.Verification@CVSCaremark.com | |
| Tufts | All | 617-972-9475 | |
| UHC | Preferred Dade | 501-262-7070 | |
| UHC | SCO | 855-250-2168 | |
| UHC | Senior D | 702-304-7460 | |
| UHC | HMO, PPO, RPPO, PFFS | 888-950-1170 | |
| UHC | PDP | 888-950-1170 | |
| United American | United American | 972-569-3678 | |
| United of Omaha | United of Omaha | 866-799-9076 | |
| WellCare | WellCare | MAPD Fax# 1-866-473-9124 PDP Fax# 1-866-388-1521 | |
| WellCare BOR Change | BOR Change | (866) 473-9124 |