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Generations Advantage Online Enrollment Form 2025

Step 1 of 8. Just a few minutes away from being insured!
  • Enrollment Eligibility
  • Identity
  • Plan Selection
  • Payment Method
  • Primary Care Physician
  • Additional Information
  • Summary
  • Confirmation

Certify Your Eligibility For An Enrollment Period * Required Fields

Typically, you may enroll in a Medicare Advantage plan only during Medicare’s Annual Enrollment Period from October 15 through December 7 of each year. There are exceptions that may allow you to enroll in a Medicare Advantage plan outside of this period.

Please read the following statements carefully and check the box if the statement applies to you. By checking any of the following boxes you are certifying that, to the best of your knowledge, you are eligible for one of Medicare's enrollment periods. If we later determine that this information is incorrect, you may be disenrolled.

Annual Enrollment Period

Initial Enrollment Period & other new to Medicare situations

Medicare Advantage Plan Open Enrollment Period

Special Enrollment Periods

Other

If none of these statements applies to you or you’re not sure, please contact Martin’s Point Generations Advantage at 1-888-408-8285 (TTY users should call 711 number) to see if you are eligible to enroll. We are available 8 am–8 pm, seven days a week from October 1 to March 31; and Monday through Friday the rest of the year.

Health care provider(s) who can confirm your chronic condition:

Provider #1

PO Box is not allowed.

Provider #2 (if applicable)

PO Box is not allowed.

Please Read this Important Information

If you currently have health coverage from an employer or union, joining Martin’s Point Generations Advantage could affect your employer or union health benefits. You could lose your employer or union health coverage if you join Martin’s Point Generations Advantage.

Read the communications your employer or union sends you. If you have questions, visit their website, or contact the office listed in their communications. If there isn’t any contact information, your benefits administrator or the office that answers questions about your coverage can help.

Your session will expire
For your security, your session will expire in 30 minutes and your application won’t be saved.
Have questions? We’re here to help.

Talk to a health benefits specialist: Available 8am–8pm, Monday to Friday. From October 1 to March 31, we’re here 7 days a week, & Monday to Friday the rest of the year.

Enroll:
1-800-603-0652
(TTY: 711)