Enroll in a 2011 plan
It's EASY to enroll ... in-person or by mail or fax.
If you're ready to become a Samaritan Advantage Health Plan HMO member, that's great! Our promise is to provide you with the coverage you need and the outstanding service you deserve.
ENROLL IN-PERSON. Stop by our offices in Corvallis at 815 NW Ninth Street, Monday – Friday, 8:30 a.m to 5 p.m. One of our friendly staff can assist you, if needed, in completing your enrollment form.
ENROLL BY MAIL OR FAX. Simply download the enrollment form (below), complete the form and mail or fax the form to us. You will need Adobe Acrobat Reader in order to view these documents. Get Acrobat Reader here for free.
2011 Enrollment form (H3811_EN150 Approved)
Instructions
Mail to:
Samaritan Health Plans
Attn: Enrollment Dept.
PO Box M
Corvallis, OR 97339
Fax to:
(541) 768-4294, Attn: Enrollment Dept.
The Medicare Annual Enrollment Period for 2011 benefits ended on December 31, 2010. To have Medicare Part D prescription coverage or other Medicare Advantage benefits on January 1, 2011, you must have enrolled in a plan by December 31, 2010.
EXCEPTIONS: You may apply for Samaritan Advantage coverage within 3 months of your 65th birthday, no matter when that birthday occurs. Additionally, some beneficiaries, including those that are disabled as defined by Medicare, are allowed to enroll in or switch plans at other times.
Contact us for details.
Other options for enrolling:
Medicare beneficiaries may also enroll in a Samaritan Advantage Health Plan (HMO) through the
Centers for Medicare & Medicaid Services Online Enrollment Center.
Last modified: January 4, 2011
H3811_MA4002 CMS Approved 10.22.2010