How to Enroll
Our plans are only available in certain places. Make sure you live in our service area.
Medicare Prescription Payment Plan (M3P). Learn more.
Enroll By Phone
Enroll By Mail
2024 Medicare plans. Coverage begins Jan 1, 2024
- 2024 Enrich Rx Enrollment Form
- 2025 Health Alliance Medicare Enrollment Form
- 2024 Guide Medicare Enrollment Form
- 2024 Guide Medicare Enrollment Form (Scott County, IA only)
- 2025 Guide Medicare Enrollment Form (Scott County, IA only)
- 2025 HMO Basic Rx2 Medicare Enrollment Form
- 2024 Enrich Medicare Enrollment Form
- 2025 Enrich Medicare Enrollment Form
- 2025 Enrich Rx Enrollment Form
- 2024 WAC Enrollment Form
- 2024 WAY Enrollment Form
To enroll during a Special Enrollment Period, include this form with your application:
- Midwest Attestation of Eligibility Form
- OSF Attestation of Eligibility Form
- Northwest Attestation of Eligibility Form
- Quad Attestation of Eligibility Form
- Reid Attestation of Eligibility Form
- Simplete Riverside Attestation of Eligibility Form
Mail applications to:
Application Processing Center
3310 Fields South Dr.
Champaign, IL 61822
Enroll In-Person
Health Alliance Connections
3301 Fields South Drive
#105
Champaign, IL 61822
8:30 a.m. to 4:30 p.m.1701 Creekside Loop #100, Building 11
Yakima, WA 98902
9 a.m. to 12 p.m. and 1 p.m. to 4 p.m. weekdays
Medicare beneficiaries may also enroll in Health Alliance Medicare through the CMS Medicare Online Enrollment Center located at Medicare.gov.