Health Choice Generations
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Health Choice Arizona
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Enroll in Health Choice Generations HMO

Enrollment Instructions Member
Registration

• You may download the English PDF form (H5587_2010_4 CMS Approved 11/23/09) or download the Spanish PDF Form (H5587_2010_4_SP). Print it and fill it out, and then mail it to the address below.

• You can choose online registration. Please note that even if you submit your online registration from our Web Site, you might need to mail or fax us a note or records from your doctor, depending on how you enter information in certain fields. If this is required, please mail your document to:
Health Choice Generations HMO
ATTN: Enrollment
410 N. 44th Street, Ste. 510
Phoenix, AZ 85008

Or fax them to: 480-760-4635

If you have questions about enrolling in Health Choice Generations HMO, please contact Member Services, 8 am - 8 pm, 7 days a week at 1-800-656-8991 (TTY users call 1-800-842-4681) or e-mail Comments@iasishealthcare.com.

Or, you can enroll into Health Choice Generations HMO through the Medicare Online Enrollment Center by clicking on the following link: www.medicare.gov. Scroll down to the bottom of the page and look for "Search Tools"; click on the link: "Find out if You are eligible for Medicare and when You can enroll" or calling Medicare directly at 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048. Calls to Medicare are free and they are available, 24 hours a day, 7 days a week.

To enroll membership electronically, please click the button to continue


The Health Choice Generations Member Registration and Status Check will be off-line for
maintenance on 10/31/2008 from 9:00:00 pm to 4:00:00 am.

Member Registration Status
To check your registration status, please click the button to continue