How to Enroll
Thank you for your interest in becoming a member of Allwell from Silver Summit Healthplan. We are excited for you to join us!
There are three (3) ways to enroll:
Call us and one of our licensed sales and enrollment representatives will help you through the enrollment process.
1-800-606-3604; (TTY: 711)
Paper Application Instructions
- Download and print the paper application.
- Please fill out the paper application.
- Check either YES or NO box for items 1 through 5 on page 5.
- Enter your Primary Care Physician's name.
- Sign and date the enrollment application for Allwell on page 7.
- Check any box on page 9 that applies to you.
- Submit your application via mail or fax.
Paper Application Submission Options
Mail Your Application
Send your application to:
Medicare Enrollment Department
P.O. Box 2020
Farmington, MO 63640-2011
Fax Your Application
Fax your application to:
Y0020_14858WEBMOE_C_2020 _Accepted 10152019
See 2020 information for more details.