Health First Health Plans Medicare Referral Form

Important Reminder: The prospective member must contact our Customer Service Department with any questions or to request an enrollment form or in-home appointment. The prospective member may call toll-free 1.800.716.7737 (TDD/TTY relay: 1.800.955.8771) weekdays from 8 a.m. to 8 p.m. and Saturdays from 8 a.m. to noon. From October 1 to February 14, we're available seven days a week from 8 a.m. to 8 p.m.
Per the Centers for Medicare & Medicaid Services (CMS) Health First Health Plans cannot outreach to the prospective member.



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Friend, Family Member or Neighbor
Existing Client
Inbound telephone call
Retiring from existing group plan

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