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How to Enroll

IMPORTANT NOTICE FOR MEDICARE ADVANTAGE – PEACEHEALTH NOT IN-NETWORK AS OF 1/1/2020

HEALTH NET HEALTH PLAN OF OREGON, INC. WILL NOT HAVE A CONTRACT WITH PEACEHEALTH BEGINNING JANUARY 1, 2020. AS A RESULT, PEACEHEALTH IS NON-CONTRACTED AND WILL NOT BE IN-NETWORK WITH ANY HEALTH NET HEALTH PLAN OF OREGON MEDICARE ADVANTAGE PLANS. NON-CONTRACTED PROVIDERS MAY NOT ACCEPT HEALTH NET INSURANCE.

Thank you for your interest in becoming a member of Health Net Medicare Advantage for Oregon and Washington. We are excited for you to join us!

There are three (3) ways to enroll:

Online


Click on the link below to go to our online website tool where you can choose your plan and apply now. 

By Phone

Call us and one of our licensed sales and enrollment representatives will help you through the enrollment process.

1-800-949-6192; (TTY: 711)

By Mail or Fax

Download and print your enrollment application. Once you fill it out, mail it or fax it to us. If you need help, contact Member Services to speak to a licensed sales agent. 

 

Paper Application Instructions

  1. Download and print the paper application.
  2. Please fill out the paper application.
  3. Check either YES or NO box for items 1 through 5 on page 4.
  4. Enter your Primary Care Physician's name.
  5. Sign and date the enrollment application for Health Net on page 6.
  6. Check any box on page 8 that applies to you.
  7. Submit your application via mail or fax.

Paper Application Submission Options

Mail Your Application

Send your application to:

Medicare Enrollment Department
P.O. Box 2020
Farmington, MO 63640-2011

Fax Your Application

Fax your application to:

1-844-222-3180

 

Y0020_14858WEBMOE_C_2020 _Accepted 10152019