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How to Enroll in a Prominence Medicare Advantage Plan

You can enroll in Prominence Health Plan’s Medicare Advantage plan if you have Medicare Parts A and B and it is either the Annual Election Period (AEP), Medicare’s Open Enrollment Period or you have a Special Election Period.

Learn more about enrollment periods

Three Ways to Enroll

  • If you are enrolling in a Prominence Health Plan Medicare Advantage plan for the first time, you can enroll online, by phone or by mail.
  • Current members: please enroll online, by phone or contact your broker.
You will need your Medicare card to enroll online. Completing the form should take approximately 15 minutes.

  1. Open the Enrollment Request Form from the link below
  2. Select your state and desired plan
  3. Complete the form as instructed

NOTE: You must complete the form in one sitting. If the form is not completed, your information will not be saved.

Enroll Online

  • Call our secure line at 866-747-8855 (TTY: 711) and one of our representatives will assist you.
  • Make sure to have your Medicare card and information with you when you call.
  1. Download and print the enrollment form for your region:



  1. Complete the form, making sure to select the correct plan for your county
  2. Mail completed form to:
    Prominence Health Plan
    PO Box 106143
    Jefferson City, MO 65110

Please call 866-747-8855 (TTY: 711) with any questions.

Waiting until three months after you turn 65 or beyond three months after you retire to sign up for Medicare could result in a Late Enrollment Penalty.

Annual Election Period (AEP)

Unless you are able to participate in another enrollment period, this is the only time that you can enroll or change your Medicare plan for the following year. Medicare members typically use this time to join Medicare Part C or Medicare Part D, also known as Medicare Advantage Plans, if they did not do so previously. The AEP takes place each year between October 15 and December 7.

Medicare Advantage Open Enrollment Period (MA/OEP)

The Medicare Advantage Open Enrollment Period takes place between January 1 and March 31 of the year of coverage. The Medicare Advantage Open Enrollment Period is an opportunity to disenroll from a Medicare Advantage plan and return to original Medicare or switch to another Medicare Advantage plan.

Special Enrollment Period

You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP. Some examples include:

  • You are eligible for both Medicare and Medicaid
  • You qualify for Extra Help paying for Medicare prescription drug coverage
  • You change where you live
  • You lose your current coverage
  • You have a chance to get other coverage
  • Your plan changes its contract with Medicare

Initial Enrollment Period (IEP)

This is a 7-month window that begins 3 months prior to your 65th birthday and ends 3 months after. For example, if your birthday is in August, your IEP starts in May and ends in November.

General Enrollment Period

The General Enrollment Period falls between January 1 and March 31 each year. This enrollment period is for people who didn’t sign up for Medicare Part A and/or Medicare Part B during their Initial Enrollment Period. Original Medicare coverage would then start in July of the same year.

Last update 9/14/2023

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