Medicare Enrollment Process

Follow three simple steps to fax, email, or mail in your application!

  1. Complete the following application online or print it and complete it by hand English | Espanol.
  2. Sign the application.  If you selected Electronic Funds Transfer for your payment option, be sure to sign that section, too.  All fields within the Payment Option section must be completed.
  3. Submit the Application to Rocky Mountain Health Plans using your preferred method:

    1. Fax – 970-255-5666  A Fax Cover Sheet is included with the Enrollment Application.
    2. Email – Scan the document and include it as an email attachment to
    3. Postal Service
      Rocky Mountain Health Plans
      Attn: Medicare Enrollment
      P.O. Box 10600
      Grand Junction CO 81502-5600

Appointment of Representative
Notice of Privacy Practices
Authorization to Use or Disclose Specific Information
Attestation of Eligibility for an Enrollment Period

This information is available for free in other languages. Please call our Customer Service number at 888-282-1420 (TTY dial 711). Hours are 8am - 8pm, 7 days/week, Oct. 1–Feb.14, and 8am - 8pm, M-F, Feb.15–Sept.30. Esta información está disponible gratuitamente en otros idiomas. Por favor llame a la línea de Atención a Clientes, al 888-282-1420 (TTY marque 711). Horario  de 8am - 8pm, 7 días a la semana, del 1 de octubre al 14 de febrero; y de 8am - 8pm, de lunes a viernes, del 15 de febrero al 30 de septiembre.

This page was last updated: xx/xx/xx.  Please call to confirm you have the most up to date information about our Medicare Cost plans. Medicare Disclaimers

RMHP is a Medicare-approved Cost plan. Enrollment in RMHP depends on contract renewal. H0602_MS_MC500WEB_RMHP1 Pending CMS Review.

For a Licensed RMHP Medicare Salesperson Call:

888-251-1330 (TTY: 711).

For Customer Service Call:

970-244-7912 or 888-282-1420 (TTY: 711)


8 a.m. to 8 p.m., Mountain Time. 

Oct. 1- Feb. 14- Open 7 days per week.

Feb. 15- Sept. 30- Open M-F.

Para Asistencia en Español:

Llame al 888-282-1420