Enrollment Form
2019

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Please contact Care N' Care if you need information in another language or format (Braille).













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  • Review the full list of benefits found in the Evidence of Coverage (EOC), especially for those services for which you routinely see a doctor. Visit https://www.cnchealthplan.com or call 1-877-665-2622 to view a copy of the EOC.

  • Review the provider directory (or ask your doctor) to make sure the doctors you see now are in the network. If they are not listed, it means you will likely have to select a new doctor, or pay a higher share of the cost.
  • Review the provider directory (or ask your doctor) to make sure the doctors you see now are in the network. If they are not listed, it means you will likely have to select a new doctor, or pay a higher share of the cost.

  • Review the pharmacy directory to make sure the pharmacy you use for any prescription medicines is in the network. If the pharmacy is not listed, you will likely have to select a new pharmacy for your prescriptions.


  • If you select a plan with a monthly premium then in addition to your monthly plan premium you must continue to pay your Medicare Part B premium. This premium is normally taken out of your Social Security check each month.
  • You must continue to pay your Medicare Part B premium. This premium is normally taken out of your Social Security check each month.

  • Benefits, premiums and/or copayments/co-insurance may change on January 1, 2020.

  • Our plan allows you to see providers outside of our network (non-contracted providers). However, while we will pay for covered services provided by a non-contracted provider, the provider must agree to treat you. Except in an emergency or urgent situations, non-contracted providers may deny care. In addition, you will pay a higher co-pay for services received by non-contracted providers.

  • Except in emergency or urgent situations, we do not cover services by out-of-network providers (doctors who are not listed in the provider directory).


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  • Care N' Care Health Plan
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  • Continue your application by clicking the "Next" button below
  • Change your selections by clicking the "Previous" button below

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Have a question? We can help!

By Phone:

1-877-665-2622 (TTY 711), 8 am to 8 pm, seven days a week (CST).

By Email:

info@cnchealthplan.com