You may enroll in a Medicare Prescription Drug plan during one of the following election periods.

Initial Enrollment Period

The initial enrollment period is the period during which an individual is first eligible to enroll in a Part D plan. In general, an individual is eligible to enroll in a Part D plan when an individual is entitled to Part A OR enrolled in Part B, AND lives in the service area of a Part D plan.

Annual Election Period

The Annual Election Period (AEP) occurs November 15 through December 31 of every year, There is one AEP enrolment/disenrollment choice available for use during this period. Once the enrollment/disenrollment is effective, the individual has exhausted this choice. During this time, you can switch from one way of getting Medicare to another. You have the opportunity to choose the plan that’s best for you. The change will take effect on January 1st of the upcoming benefit year.

Special Election Period

The Special Election Period is a special period of time during which you may enroll. For instance if you:

• have just moved into the plan’s service area;
• are enrolled in another prescription drug plan or a Medicare Advantage plan whose 2009 contract is terminated;
• have full Medicaid benefits or prescription drug assistance through PACE.

To obtain more information about these election periods, please call the Telemarketing Department at 1-866-456-1695 (TTY/TDD 1-866-456-1683), 8 a.m. to 8 p.m., seven days a week.

Eligibility

Review the basic eligibility requirements and other important information that follows.

Enroll online

Complete the online enrollment form.

Enroll by phone

Call the Telemarketing Department toll-free at 1-866-456-1695 (TTY/TDD 1-866-456-1683), 8 a.m. to 8 p.m., seven days a week.

Enroll by mail

Download the application form.

An application (in PDF format) will open in a new window for you to download.

In order to view the application, you will need to have the Acrobat Reader software. For more information about PDFs and to download the free software, visit the Adobe Acrobat Reader website.

When you have completed the form, print it, sign it, and mail it to:

AmeriHealth Advantage
PO Box 41514
Philadelphia, PA 19101-1514

Completing your application

If you prefer to enroll by phone, need help completing the form, or have any questions concerning our plans, just call our Telemarketing Department at 1-866-456-1695 (TTY/TDD 1-866-456-1683), 8 a.m. to 8 p.m., seven days a week.

If anyone (i.e. spouse, friend, representative) helps you fill out your application, that individual must sign the form and indicate his or her relationship to you.

No premium payment is required at time you enroll in the plan.

Once your application has been processed and approved by CMS, we will notify you of your effective date and send you your identification card and member packet that includes your  Evidence of Coverage, and other important information.