Click here for 2019 Enrollment Application
Instructions and Disclaimers
Here is how you can enroll in a Preferred Care Partners plan NOW:
1. Download, print and complete form with signature:
Application Instructions for plans above
If you are enrolling in Preferred Special Care Miami-Dade (HMO C-SNP), you must fill out the Chronic Condition Pre-Assessment Form.
Click here to download.
Please mail or fax to:
United Healthcare Medicare
P.O. Box 30770
Salt Lake City, UT 84130-0770
2. OR- Complete and submit your Enrollment Form via the Medicare website
By completing and sending the enrollment election form to be enrolled, you are sending an actual enrollment election to Preferred Care Partners.
You must complete and sign an enrollment election form. Except for forms that are faxed to our plan, you should submit original, not photocopied forms.
Once we receive your enrollment election form, and prior to submitting the enrollment transaction to CMS, we will contact you (via phone or mail) to confirm that you still intend to enroll in the plan.
If your enrollment election form is incomplete, we may need to contact you to acquire additional information to complete your election.
After submitting the enrollment transaction to CMS, we may send you an acknowledgement letter notifying you that we have submitted the transaction to CMS for processing.
After we receive confirmation from CMS' systems of the enrollment transaction, we will send you one of the following letters:
Below are the periods and conditions when a Medicare eligible individual may apply for enrollment in one of our plans.
Medicare beneficiaries may enroll in Preferred Care Partners through the CMS Medicare Online Enrollment Center, located at www.medicare.gov.
NOTE: Medicare beneficiaries with special exceptions, such as those who have Medicaid coverage or chronic conditions, can enroll at any time during the year. Contact us for additional information.
Open 8 a.m. to 8 p.m. 7 days a week, including holidays