Medicare Client Application Submission Processes

Below is a list, by carrier, of all the available Medicare client application submission processes. If you find we have missed one, or have incorrect information, please feel free to leave us a comment and we will take care of it right away.

AARP Medicare Supplements
Fax: 1-888-836-3985
Standard Mail:
P.O. Box 105331
Atlanta, GA 30348-5331

Aetna Medicare Advantage and PDP
Fax: 1-866-441-2341 or 1-888-665-6296
Electronic App Agent Login:
www.aetnaseniorproducts.com

Altius Medicare Advantage
Fax: 1-866-721-7936
Standard Mail:
Altius Health Plans
10421 S. Jordan Gateway Suite 400
South Jordan, UT 84095
Phone: 1-855-338-9559

American Continental
Fax: 1-877-380-2777
Attn: New Application Submission
Standard Mail:
800 Crescent Centre Drive, Suite 200
Franklin, TN 37067

Bankers Fidelity
Fax: 1-404-926-4030
Attn: Bankers Fidelity Underwriting Department
Standard Mail:
Attn: New Business
P.O. Box 105185
Atlanta, GA 30348-5185
Email: bfluw@bflic.com

Care Improvement Plus
Fax: 1-866-686-2508
Standard Mail:
CIP – Attn: Enrollment Dept.
P.O. Box 691350
San Antonio, TX 78269-1350
Overnight:
CIP – Attn: Enrollment Department
4350 Lockhill-Selma Road, Suite 300
San Antonio, TX 78249

Continental Life
Fax: 1-877-380-2777
Attn: New Application Submission
Standard Mail:
800 Crescent Centre Drive, Suite 200
Franklin, TN 37067

Dentist Direct
Fax: 1-877-966-1010
Standard Mail:
Direct Access Plans, LLC
75 Sout 500 West, Suite 200
Bountiful, UT 84010

Equitable Medicare Supplement
Fax: 1-888-352-5126
Local Fax: 801-579-3765
Standard Mail:
Equitable Life & Casualty Insurance Company
P.O. Box 2460
Salt Lake City, UT 84110-2460

Genworth
Fax: 1-877-380-2777
Attn: New Application Submission
Standard Mail:
101 Continental Place
Brentwood, TN 37027

Guarantee Trust Life
Fax: 1-847-699-8493
Standard Mail:
1275 Milwaukee Avenue
Glenview, IL 60025

Heartland
Fax: 1-800-506-8295
Standard Mail:
Medicare Supplement Administrative Office
P.O. Box 2878
Salt Lake City, UT 84110-2878
Overnight:
Medicare Supplement Administrative Office
3 Triad Center, Suite 200
Salt Lake City, 84110

Humana
Fax: 1-877-889-9936
Electronic App: Humana
Humana Electronic Application Learner’s Guide

Manhattan Life
Fax:713-583-2738
Standard Mail:
Family Life Insurance Company
Medicare Supplement Division
10777 Northwest Freeway
Houston, TX 77092

Medica Health Care Plans
Fax: 305-715-1807
Standard Mail:
Medica Health Care Plans
4000 Ponce De Leon Blvd, Suite 650
Coral Gables, FL 33146

Medico Medicare Supplement
Main Fax: 1-888-363-3420
Medico Corp Fax: 1-844-850-2550
Standard Mail:
Administrative Services
P.O. Box 10482
Des Moines, IA 50306
Electronic: My Enroller
Sign up through the Medico Website

Medico DVH
Fax: 1-888-363-3420
Standard Mail:
Administrative Services
P.O. Box 10482
Des Moines, IA 50306
Electronic: My Enroller
Sign up through the Medico Website

Molina Medicare Advantage & Duel-Eligible
Fax: 1-562-499-0732
Notes: Any questions regarding enrollment, contact Ronda Word at 1-866-440-9788 or ronda.word@molinahealthcare.com

Mutual of Omaha
Fax: 1-866-799-9076
Standard Mail:
United of Omaha
P.O. Box 3608
Omaha, NE 68103

North American Dental
Electronic: www.northamericandental.com
Phone: 801-897-1356
Email: rick.bass@gmx.com

Oxford Medicare Supplement
Fax: 1-888-5FAXAPP (1-888-532-9277)
Standard Mail:
Oxford Life Insurance Company
2721 N Central Ave
Phoenix, AZ 85004-9945
Electronic App:
1. Go to www.oxfordlife.com
2. Click on “Producer Login” and enter your username and password
3. Go to “Producer Support”
4. Click on “Online Applications”
5. Click on “Medicare Supplement Application”

Physicians Health Choice
Fax: 501-262-7070
Standard Mail:
UnitedHealthcare
P.O. Box 29650
Hot Springs, AR 71903-9973
Overnight:
UnitedHealthcare Medicare Enrollment
Attn: Xerox/ACS
3315 Central Avenue
Hot Springs, AR 71903

Preferred Care Partners
Fax: 501-262-7070
Standard Mail:
UnitedHealthcare
P.O. Box 29650
Hot Springs, AR 71903-9973
Overnight:
UnitedHealthcare Medicare Enrollment
Attn: Xerox/ACS
3315 Central Avenue
Hot Springs, AR 71903

Regence Medicare Advantage
Fax: 1-888-335-2988
Standard Mail:
Medicare Advantage/Medicare Part D
Membership Accounting MS B32M
P.O. Box 1827
Medford, OR 97501-9881

Regence Bridge Medicare Supplement
Fax: 1-866-797-1786
Standard Mail:
P.O. Box 1106
Lewiston, ID 83501-1106

SelectHealth Medicare Advantage
Fax: 1-855-442-0357
Standard Mail:
SelectHealth Advantage
P.O. Box 30196
Salt Lake City, UT 84130-9932
Electronic App:
Upload PDF enrollment forms with the click of a button:
1. Scan your application to a file on your computer
2. Log into Broker Exchange
3. Click “Medicare Enrollment Upload”
4. Click “Browse” to find the PDF File on your computer
5. Click “Upload” to transmit the file to SelectHealth
6. **Notice the Successful message when the upload is complete

Senior Dimensions
Fax: 702-304-7460
Attn: Government Programs
Standard Mail:
Senior Dimensions (HPN)
P.O. Box 15645
Las Vegas, NV 89114

Sentinel
Fax: 1-855-808-0946
Attn: Attn: New Business
Standard Mail:
Attn: New Business
P.O. Box 16960
Clearwater, FL 33766-6960
Overnight:
Attn: New Business
2650 McCormick Drive, Suite 200T
Clearwater, FL 33759

Sierra Spectrum PPO Plans
Fax: 702-304-7460
Attn: Government Programs
Standard Mail:
Sierra Spectrum (SHL)
P.O. Box 15645
Las Vegas, NV 89114

Silverscript PDP
Fax: 1-866-552-6205
Standard Mail:
SilverScript Insurance Company
Attn: Agent Processing
P.O. Box 52134 Phoenix, AZ 85072
Electronic App:
silverscriptagentportal.com
Agents must enter the enrollment application into the agent portal within 24 hours of receiving the application from the beneficiary!

Standard Life
Fax: 1-800-647-6085
Standard Mail:
P.O. Box 10627
Springfield, MO 65808

Stonebridge Medicare Supplement
Fax: 1-866-834-0437
Standard Mail:
Transamerica Life Insurance Co.
4333 Edgewood Rd NE
Cedar Rapids, IA 52499
Electronic App:
https://al.transamericaagencygroup.com/iGo/iGo.aspx

United American
Fax: 972-569-3678
Standard Mail:
P.O. Box 8080
McKinney, TX 75070

United Commercial Travelers Medicare Supplement
Fax: 1-800-948-1039
Standard Mail:
P.O. Box 159019
Columbus, OH 43215

UnitedHealthcare AARP PDP
Fax: 1-866-994-9659
Standard Mail:
UnitedHealthcare
P.O. Box 29650
Hot Springs, AR 71903-9973
Overnight:
UnitedHealthcare Medicare Enrollment
Attn: Xerox/ACS
3315 Central Avenue
Hot Springs, AR 71903

UnitedHealthcare DSNP
Fax: 501-262-7070
Standard Mail:
UnitedHealthcare
P.O. Box 29650
Hot Springs, AR 71903-9973
Overnight:
UnitedHealthcare Medicare Enrollment
Attn: Xerox/ACS
3315 Central Avenue
Hot Springs, AR 71903

UnitedHealthcare DSNP (MI, NJ, NY, PA, TN, WI)
Fax: 1-877-738-7775
Overnight:
UnitedHealthcare Medicare Enrollment
Attn: C&S Medicare
1300 River Drive, Suite 200
Moline, IL 61265

UnitedHealthcare DSNP (AZ)
Fax: 1-855-210-5123
Overnight:
UnitedHealthcare Medicare Enrollment
Attn: C&S Medicare
1300 River Drive, Suite 200
Moline, IL 61265

UnitedHealthcare Medicare Advantage
Fax: 501-262-7070
Standard Mail:
UnitedHealthcare
P.O. Box 29650
Hot Springs, AR 71903-9973
Overnight:
UnitedHealthcare Medicare Enrollment
Attn: Xerox/ACS
3315 Central Avenue
Hot Springs, AR 71903

United of Omaha
Fax: 1-866-799-9076
Standard Mail:
United of Omaha
P.O. Box 3608
Omaha, NE 68103

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