What You Need
to Get Started

A graphic of a checklist
Your Checklist

Make sure to have the following information with you to make enrolling even easier.

  • Personal Information
  • Medicare Card
  • Medicaid Card (if applicable)
  • Long Term Care Institution Information (if applicable)
  • Other Insurance Coverage Information (if applicable)
  • Social Security Card (if enrolling in the Viva Medicare Extra Value (HMO SNP) or Extra Care (HMO SNP) plan)
  • Electronic Funds Transfer (EFT) form (if applicable)
PLEASE READ

By completing the following enrollment application, you are applying for Viva Medicare coverage. By starting the application, you consent for a Viva Health representative or licensed salesperson to contact you at the number and/or email address you provide.

Be aware that using the "back" browser button will direct you to the Viva Medicare Customer Service web page. You cannot go back and edit any data once you have proceeded past that page. Upon completion, Viva Medicare will be happy to assist you in making any edits to your application.

Enroll in Viva Medicare Now

Medicare beneficiaries may also enroll in Viva Medicare through the Centers for Medicare & Medicaid Services Online Enrollment Center, located at http://www.medicare.gov/. For more information, contact Viva Medicare via phone at 1-888-830-VIVA (8482).

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Viva Health Cafe Locations
The Viva Health Café is a stress-free place where you can attend fun, free events and get answers to all your Medicare questions.