Our Enrollment Process

Provider Partners Health Plan is an insurance product sold through licensed and appointed agents.  The agent will complete a “Scope of Appointment” form and detail what would be discussed during the sales presentation.  After that, the agent will go through the elements of the plan with specific focus on eligibility, service area, covered services and cost sharing.

Individuals who want to enroll after the presentation must complete an Enrollment Form and return it to the agent for processing.

Once the enrollment form is processed, the new member will receive a welcome packet with confirmation notice and the plan’s ID card along with information on how to access our formulary, provider directory and pharmacy directory.

Coverage is generally effective the first of the following month.

  • Illinois: Enrollment completed any time in 2019 will be effective the 1st of the following month.
  • Maryland: Enrollment completed any time in 2019 will be effective the 1st of the following month.
  • Ohio: Enrollment completed any time in 2019 will be effective the 1st of the following month.
  • Pennsylvania: Enrollment completed any time in 2019 will be effective the 1st of the following month.

Download Provider Partners Illinois HMO SNP Enrollment Form
Download Provider Partners Maryland HMO SNP Enrollment form
Download Provider Partners Ohio HMO SNP Enrollment Form
Download Provider Partners Pennsylvania HMO SNP Enrollment form

Contact our Member Services number at 1-800-405-9681 for additional information. (TTY users should call 711). Calls to this number are free. Hours are from 8 a.m. to 8 p.m., seven (7) days a week from October 1st to March 31st. Hours are 8 a.m. to 8 p.m., Monday through Friday and 8 a.m. to 7 p.m., Saturday and Sunday from April 1st to September 30th.  Messaging service used weekends, after hours, and on federal holidays.

Provider Partners Illinois Advantage offered by Provider Partners Health Plan is a health plan with a Medicare Contract. Enrollment in Provider Partners Illinois Advantage depends on contract renewal.
H8067_002_PPHPWEB CMS Pending

Provider Partners Maryland Advantage offered by Provider Partners Health Plan is a health plan with a Medicare Contract. Enrollment in Provider Partners Maryland Advantage depends on contract renewal.
H8067_001_PPHPWEB CMS Pending

Provider Partners Health Plan of Ohio is a Health Plan with a Medicare Contract. Enrollment in Provider Partners Health Plan of Ohio depends on contract renewal.
H7119_001_PPHPWEB CMS Pending

Provider Partners Pennsylvania Advantage offered by Provider Partners Health Plan of Pennsylvania is a Health Plan with a Medicare Contract. Enrollment in Provider Partners Pennsylvania Advantage depends on contract renewal.
H4093_001_PPHPWEB CMS Pending

Last updated 2/1/2019

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