RMHP Medicare Application Instructions Page
1. Open the RMHP Medicare Enrollment Application.
2. Complete the Application by typing your information into the highlighted field.
Go to Step 3.
Or you may print the Application and complete by hand. Go to Step 4.
3. Once you have completed the Application, print out the document.
4. Sign the Application. If you selected Electronic Funds Transfer or Credit Card for your payment option, be sure to sign here as well. All fields within your preferred Payment Option must be completed.
5. Submit the Application to Rocky Mountain Health Plans by:
a. Fax - 970-255-5666. A Fax Cover Sheet will be printed with the Enrollment Application for your use.
b. Email - Scan document and include as an email attachment
MedicareSalesGroup@rmhp.org
c. Postal Service -
Rocky Mountain Health Plans
Attn: Medicare Enrollment
P.O. Box 10600
Grand Junction CO 81502-5600
If you have any questions about completing your application, you may call us at 888-251-1330 (TTY: 711) to speak with a Sales Representative. Para asistencia en español llame al 888-282-1420.
Medicare beneficiaries may enroll in a Rocky Mountain Medicare plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. By clicking on this link, you will be leaving the RMHP website.
RMHP's contract with Medicare is renewed annually. The availability of coverage beyond the end of the current contract year is not guaranteed. RMHP has contracted with Medicare to provide benefits since 1977.
This page was last updated: 03/07/12. Please call to confirm you have the most up to date information about our Medicare Plans. Full list of Medicare Disclaimers.
Medicare-approved Cost plan. H0602_1037027 MC150WEB Approved 04102012
