Enroll by Mail

HAP wants to make enrollment as simple as possible. To enroll by mail, begin by downloading the enrollment form for one of the plans listed below. Then, just complete the form and mail it to us at the address shown on the form.

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Enrolling in a 2016 Plan?

If you are newly eligible to Medicare or qualify for a Special Enrollment Period you can still enroll in a 2016 Medicare plan.

Alliance Medicare PPO (PDF)
HAP Senior Plus (HMO) – Henry Ford (PDF)
HAP Senior Plus (HMO-POS) – Expanded Network (PDF)
Alliance Medicare Supplement (PDF)

You must have Adobe Reader to download these files. Download for free (You are leaving a Medicare-approved site)

Have questions?

HAP can help! Send us an email or give us a call and speak with a licensed HAP Medicare Sales Representative. Contact Us

Medicare beneficiaries may also enroll through the CMS Medicare Online Enrollment Center located at: www.medicare.gov. (You are leaving a Medicare-approved site)
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