Enrollment Application 2023

Click here for 2024 Enrollment Application

You can enroll in a Preferred Care Network plan RIGHT NOW by doing the following:

1. Download, print and complete form with signature:

Enrollment Application

MedicareMax (HMO) Miami-Dade
MedicareMax (HMO) Broward

Application Instructions

Instructions for plans above

Plan Recap

Enrollment Application

MedicareMax Chronic (HMO C-SNP) Miami-Dade and Broward NEW

Application Instructions

Instructions for plan above

Plan Recap

If you are enrolling in Preferred Special Care Miami-Dade (HMO C-SNP), you must fill out the following form:

Chronic Condition Pre-Assessment Form

Enrollment Application

MedicareMax Plus (HMO D-SNP) Miami-Dade and Broward

Application Instructions

Instructions for plan above

Plan Recap

Need Assistance Completing This Form?

MedicareMax (HMO) Miami-Dade

MedicareMax (HMO) Broward

MedicareMax Chronic (HMO C-SNP) Miami-Dade and Broward NEW

	1-844-723-6471 (TTY - 711) Toll-Free
	1-888-950-1170

1-844-723-6471

(TTY - 711) Toll-Free

1-888-950-1170

MedicareMax Plus (HMO D-SNP) Miami-Dade and Broward

	1-866-367-7525 (TTY - 711) Toll-Free
	1-888-950-1169

	Open 8 a.m. a 8 p.m., 7 days a week

OR:

2. Enroll online by completing and submitting your enrollment form electronically!

Disclaimer information

Preferred Care Network is insured through UnitedHealthcare Insurance Company or one of its affiliated companies, for Medicare Advantage Plans: A Medicare Advantage organization with a Medicare contract. For Dual Special Needs Plans: A Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program Enrollment in the plan depends on the plan's contract renewal with Medicare.Benefits, features and/or devices vary by plan/area. Limitations and exclusions apply. Network size varies by market. Every year, Medicare evaluates plans based on a 5-star rating system. The star rating is for 2023.