
Formas en Español
Formulario
Plan documents
If you are a Premera Medicare Advantage member, the name of your plan can be found on the front of your Premera ID card.
Enroll in a new plan
You can enroll in a Medicare Advantage Plan when you first become eligible for Medicare, or during certain times of the year. For more information on eligibility and enrollment, refer to our Medicare Guidebook (.pdf).
2023 enrollment forms and documents
- Lista de Verificación de preinscripción
- Formulario de Solicitud de Inscripción
- Formulario de Selección del Plan
- Resumen de Beneficios
Premera Medicare Advantage Star Ratings
The Medicare Star Rating is based on quality, service, and member satisfaction.