Senior woman working on paperwork at a desk.

How to Enroll

Please contact your Erickson Advantage Licensed Sales Agent located in the Erickson Advantage office located on your campus.

Enrollment forms are located below—your Erickson Advantage Licensed Sales Agent will assist you in deciding which plan may best meet your needs.

Signature with Drugs, Signature with Drugs Plan - PDF File opens in a new window English | Signature with Drugs Plan - PDF File opens in a new window Spanish

Signature Without Drugs, Signature Without Drugs Plan - PDF File opens in a new window English | Signature Without Drugs Plan - PDF File opens in a new window Spanish

Champion, Champion Plan - PDF File opens in a new window English | Champion Plan - PDF File opens in a new window Spanish

Freedom, Freedom Plan - PDF File opens in a new window English | Freedom Plan - PDF File opens in a new window Spanish

Guardian, Guardian Plan - PDF File opens in a new window English | Guardian Plan - PDF File opens in a new window Spanish

Before completing an enrollment form, please read the disclaimer information provided.


What You Need to Know About Your Medicare Advantage Plan

Enrollment guides are located below—your Erickson Advantage Health Resource Manager will assist you in deciding which plan may best meet your needs.

Signature with Drugs, Signature with Drugs Enrollment Guide - PDF File opens in a new window English | Signature with Drugs Enrollment Guide - PDF File opens in a new window Spanish

Signature Without Drugs, Signature Without Drugs Enrollment Guide - PDF File opens in a new window English | Signature Without Drugs Enrollment Guide - PDF File opens in a new window Spanish

Champion, Champion Enrollment Guide - PDF File opens in a new window English | Champion Enrollment Guide - PDF File opens in a new window Spanish

Freedom, Freedom Enrollment Guide - PDF File opens in a new window English | Freedom Enrollment Guide - PDF File opens in a new window Spanish

Guardian, Guardian Enrollment Guide - PDF File opens in a new window English | Guardian Enrollment Guide - PDF File opens in a new window Spanish


How to Become an Authorized Representative For Your Friend or Family Member

To become an authorized representative, you'll need to download and print the Appointment of Representative Form. Both you and the person you wish to represent will need to sign the form.

PDF File opens in a new window APPOINTMENT OF REPRESENTATIVE FORM
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The Erickson Advantage Welcome Call

After enrollment in the Erickson Advantage plan with or without Prescription Benefits, you can expect a welcome call from the Erickson Advantage Member Services representative to:

  • Verify all of your contact information.
  • Review information you will be receiving about your health care status.
  • Verify you have an appointment with your primary care physician.

New Member Orientation Meeting

It may be beneficial for you and/or a family member to attend a new member orientation meeting. This meeting focuses on how you can best maximize all the services available to you as an Erickson Advantage plan member with or without Prescription Benefits.

At this meeting, we will:

  • Review your covered Medicare benefits.
  • Explain the additional services beyond Medicare you receive including care coordination services and health education/wellness programs.