A Healthy CollaborationSM

How to Enroll in PrescribaRxSM

The Annual Enrollment Period for coverage in 2009 has ended, but you can still enroll if you meet certain criteria.

If you have questions about your enrollment eligibility, please call PrescribaRx at 1-800-765-4576 (TTY for the hearing impaired: 1-800-777-9083) 8 AM to 8 PM, 7 days a week, to see if you are eligible to enroll.

Before you enroll, make sure you have your Medicare card with you. Also, if you plan on paying your monthly plan premium with an automatic deduction from your bank account, have your bank information available.

Prior to completing the enrollment form, please read the enrollment disclaimer information.

You can enroll in several ways:

  1. Enroll online by submitting our secure online form.

  2. Or, download a printable enrollment form to mail to us.

  3. Or, talk to a licensed agent and enroll using a paper application.

  4. Or, call a PrescribaRx Member Service Representative at 1-800-765-4576 (TTY for the hearing impaired: 1-800-777-9083) 8 AM to 8 PM, 7 days a week, to enroll over the phone.

 

S5597_S5825_C0008_09P0043_v2 (09/2009) Last updated: 09/09/2022

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