How do you enroll in Molina Medicare Complete Care (HMO SNP) plan?

Below is the breakdown of service areas between the two Michigan plans offered by Molina Healthcare:

Molina Medicare Complete Care (HMO SNP) H5926-001 – Allegan, Arenac, Barry, Bay, Clare, Genesee, Gratiot, Huron, Kent, Lake, Lapeer, Livingston, Macomb, Mason, Mecosta, Monroe, Montcalm, Muskegon, Newaygo, Oakland, Oceana, Osceola, Ottawa, Saginaw, Sanilac, Shiawassee, Tuscola, Washtenaw, Wayne

Molina Medicare Complete Care (HMO SNP) H5926-004 – Antrim, Branch, Charlevoix, Crawford, Grand Traverse, Kalkaska, Leelanau, Manistee, Missaukee, Otsego, Roscommon, Wexford

Please follow the instructions and complete the Enrollment Form, today.
We encourage you to read the Summary of Benefits before completing an Individual Enrollment Request form.
 

2020 Molina Medicare Complete Care (HMO SNP) Online Enrollment Form

icon PDF2020 Molina Medicare Complete Care (HMO SNP) Enrollment Instructions

icon PDF2020 Molina Medicare Complete Care (HMO SNP) Enrollment Form

2021 Molina Medicare Complete Care (HMO SNP) Online Enrollment Form

icon PDF2021 Molina Medicare Complete Care (HMO SNP) Enrollment Instructions

icon PDF2021 Molina Medicare Complete Care (HMO SNP) Enrollment Form

 

Following Steps 1 – 5 of the Enrollment Instructions PDF above will assist you with the enrollment process.

If you need help completing this enrollment form or have questions about plan benefits prior to enrollment, please call us Toll Free: (866) 403-8293, TTY/TDD: 711, Monday to Saturday, 8:00 a.m. to 8:00 p.m. local time. Molina Medicare determines when your Enrollment Form is considered to be complete based on Medicare enrollment guidelines. The Enrollment is subject to approval from the Centers for Medicare & Medicaid Services (CMS). If your enrollment is not accepted by CMS, we will notify you immediately.

 

CMS Medicare Online Enrollment Center

Medicare beneficiaries may also enroll in the Molina Medicare Complete Care (HMO SNP) plan through the CMS Medicare Online Enrollment Center located at www.medicare.gov .

 

*Printed copies of information posted on our website are available upon request.
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