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2011 Summary of Benefits
2011 Evidence of Coverage

How to Contact Us:

Telephone: 800.475.8466

TTY: 800.659.2656

Fax: 719.589.4901

Address:
700 Main Street, Suite 100
Alamosa, CO 81101

Hours: 8:00 am-8:00 pm
7 days a week

READY TO ENROLL

 Now that you’ve selected the plan that’s right for you, it's easy for you to enroll!

All you have to do is click the button below to download an Application, complete it, sign it, and mail it to us at:

Colorado Choice Health Plans
Attn: Medicare Coordinator
700 Main St, Suite 100
Alamosa, CO  81101

 

It’s that simple!

If you live in Bent, Chaffee, Crowley, Custer, Fremont, Huerfano, Las Animas, Otero, Prowers, and Yuma Counties, click below to download an application.
Enroll Now

2012 Application

If you live in Alamosa, Conejos, Costilla, Mineral, Rio Grande, and Saguache Counties, click below to download an application.
Enroll Now SLV

2012 San Luis Valley Counties Application

Call us at 800.475.8466! We have Medicare Coordinators on staff available to talk with you. 

After you enroll:

  • Shortly after we receive your Application we will confirm it is complete and signed then send you a letter confirming receipt. The letter will include your proposed effective date.
  • We will send your application to the Centers for Medicare and Medicaid Services (CMS) for approval to notify them that you have applied to join one of Colorado Choice’s Medicare Plans (Cost).
  • Once approved, you will receive a welcome letter confirming your effective date with us, along with your member identification (ID) card and other member materials.

Customer Service can be reached at 800-475-8466 toll free or 719-589-3696, 8:00 a.m. to 8:00 p.m., 7 days a week. If you are hearing impaired and use TTY equipment, call 1-800-659-2656 (Para asistencia en español llame al 1-800-475-8466).

You may also enroll in Colorado Choice’s Medicare Plans (Cost) through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov


A Health Plan with a Medicare contract.

DISCLAIMER
We renew our contract with Medicare annually. The availability of coverage beyond the end of the current year is not guaranteed.

Benefits, premium and/or copayments/coinsurance may change each year on January 1. Benefits may be subject to copayments, limitations and/or restrictions. See the Evidence of Coverage or contact Customer Service for details.

The benefit information contained herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.

You are eligible to enroll if you are entitled to Medicare Part A and enrolled in Medicare Part B and you live in the service area. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. Eligible beneficiaries can enroll in Colorado Choice at any time.

You can use any doctor who is part of Colorado Choice's network. You may also go to doctors outside of our network. We may not pay for services you receive outside of our network, but Medicare will pay for its share of charges it approves. You will be responsible for paying the Medicare deductible and coinsurance for those services, unless they were authorized in advance by Colorado Choice.

Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment and any applicable conditions associated with using the plan benefits.

Information is available in alternative formats or languages. Please call 1-800-475-8466 for details. Se puede presentar la información acerca del plan en un formato o idioma distinto. Para solicitar un documento en español, favor de llamar a Atención al Cliente, al número telefónico indicado debajo.

For more information, contact Customer Service at 1-800-475-8466 toll free or 719-589-3696, 8:00 a.m. to 8:00 p.m., 7 days a week. If you are hearing impaired and use TTY equipment, call 1-800-659-2656 (Para asistencia en español llame al 1-800-475-8466.


Information is current as of 11/27/2011.  Please contact our Customer Services department to verify that you have the most up to date information.

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