Enroll Online

Find a plan that meets your needs and complete your application online. Visit our enrollment website and enter your zip code to get started.

Enroll By Phone

Call us and one of our licensed sales and enrollment representatives will help you through the enrollment process.

1-844-480-0680 (TTY: 711)

From October 1 – March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. From April 1 – September 30, you can call us Monday – Friday from 8 a.m. to 8 p.m. A messaging system is used after hours, weekends, and on federal holidays.

Enroll By Mail or Fax

Download and print your enrollment application. Once you fill it out, mail it or fax it to us. If you need help, contact Member Services to speak to a licensed sales agent.

Wellcare CalViva Health Net Dual Align (H3561-007) Plan

• Enrollment Paper Application (PDF): English
• Enrollment Paper Application (PDF): Chinese
• Enrollment Paper Application (PDF): Hmong
• Enrollment Paper Application (PDF): Spanish

Wellcare By Health Net Dual Special Needs Plans (D-SNP)

• Enrollment Paper Application (PDF): English
• Enrollment Paper Application (PDF): Arabic
• Enrollment Paper Application (PDF): Armenian
• Enrollment Paper Application (PDF): Cambodian/Khmer
• Enrollment Paper Application (PDF): Chinese
• Enrollment Paper Application (PDF): Farsi
• Enrollment Paper Application (PDF): Hmong
• Enrollment Paper Application (PDF): Korean
• Enrollment Paper Application (PDF): Russian
• Enrollment Paper Application (PDF): Spanish
• Enrollment Paper Application (PDF): Tagalog
• Enrollment Paper Application (PDF): Vietnamese

All other Wellcare By Health Net Medicare Advantage Plans

• Enrollment Paper Application (PDF): English
• Enrollment Paper Application (PDF): Chinese
• Enrollment Paper Application (PDF): Spanish

Pre-enrollment Qualification Form (required for HMO C-SNP Enrollments)

• Pre-enrollment Qualification Form (PDF): English
• Pre-enrollment Qualification Form (PDF): Spanish