Skip to main content
Text Size Default Font Size Medium Font Size Large Font Size Extra Large Font Size
Para el idioma Español
Toll Free 711 - TTY
8am-8 pm local time -7 days a week
Call Us


Enrollment Application 2019

Instructions and Disclaimers

Plan Recap

Here is how you can enroll in a Medica Healthcare plan NOW:

1. Download, print and complete form with signature:

Miami-Dade County

Medica HealthCare Plans MedicareMax (HMO)

Enrollment Application

Application Instructions

Broward County

Medica HealthCare Plans MedicareMax (HMO)

Enrollment Application

Application Instructions

Miami-Dade and Broward Counties

Medica HealthCare Plans MedicareMax Plus (HMO SNP)

Enrollment Application

Application Instructions


2. Enroll online by completing and submitting your enrollment form electronically!

By clicking here you are leaving the Medica HealthCare Plans Website

Need Assistance Completing This Form?


Medica Healthcare Plans MedicareMax (HMO) Miami-Dade
Medica Healthcare Plans MedicareMax (HMO) Broward

Toll Free

Medica HealthCare Plans MedicareMax Plus (HMO SNP)

Toll Free

TTY users call toll-free 711


1(501) 262-7070


8 a.m. to 8 p.m
7 days a week, including holidays

Disclaimer information

Medica HealthCare is insured through UnitedHealthcare ®Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan's contract renewal with Medicare. This information is not a complete description of benefits. Call 1-800-407-9069 Toll-Free/TTY users Call Toll-Free 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. Medicare beneficiaries may also enroll in Medica HealthCare through the CMS Medicare Online Enrollment Center located at Medicare has neither reviewed nor endorsed this information. Medicare evaluates plans based on a 5-Star rating system. Star Rating is for 2019.