MEDICARE ADVANTAGE PLAN ENROLLMENT

Please complete the form below to start the enrollment process.


Applicant Name and Contact Information

Applicant Address

The county you live in will determine the Viva Medicare plans available to you. The +4 on your zip code helps Viva Medicare determine the county because zip codes can fall in two or even three counties.

Medicare Enrollment

Please choose the date you plan to enroll.

Power of Attorney Contact Information

STOP!

Please review Viva Health’s Web Privacy Disclaimer to continue enrolling in a plan:

This privacy notice discloses the privacy practices for www.vivahealth.com regarding information we collect from our website users. This privacy notice applies solely to information collected by this website.

Information Collection, Use, and Sharing
Viva Health is the sole owner of the information collected on this site. We have access to information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone. We will use your information to respond to you regarding the reason you contacted us and/or to process your on-line enrollment application. We will not share any information you submit to us via the website with any third party outside of our organization unless the disclosure is permitted by law.

Your Access to and Control of Information
Viva Health will not use the information you submit to us to contact you regarding matters that do not pertain to your enrollment or coverage in our plan. For information submitted through our online application process or through www.vivahealth.com/medicare, you can do the following at any time by contacting us via the email address or phone number given on our website: See what data we have about you, if any. Change/correct any data we have about you. Express any concern you have about our use of your data.

Security
We take precautions to protect your information. When you submit sensitive information via this website, your information is protected both online and offline. Viva Health continually investigates and evaluates new security technologies and practices. Wherever we collect sensitive information through this website, that information is transmitted to us in a secure way. We also protect your information offline. Only employees who need the information to perform a specific job (for example, enrollment, billing or customer service) are granted access to personally identifiable information. The computers/servers in which we store personally identifiable information are kept in a secure environment.

E-Mail Security
Sending emails via the internet to Viva Health (through the links on this website or otherwise) poses certain risks that you should be aware of. Email messages may pass through private and public networks with varying levels of security which means that your email may not be completely secure (encrypted). Your email system may or may not secure (encrypt) emails, thereby compromising the privacy and integrity of the information. Therefore, we ask that you use your best judgment on what information you send to us via e-mail. If you have personal or confidential information you would like to send to Viva Health, you may want to consider calling, faxing or mailing the information instead of using email. We will preserve the content of emails you send to Viva Health, and if the response contains confidential or protected health information, we will only issue a secure (encrypted) response.

Links
This website contains links to other sites. Please be aware that we are not responsible for the content or privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of any other site that collects personally identifiable information.

For More Information or To Report A Problem.
If you have questions or need additional information, or if you believe we are not abiding by this privacy notice, you may contact Viva Health at 417 20th Street North, Suite 1100, Birmingham, AL 35203 or by telephone at 205-939-1718 (in the Birmingham area) or 1-800-294-7780. Our office hours are Monday-Friday, 8:00 a.m. – 8:00 p.m.
 
By clicking "I Agree" you acknowledge you have reviewed and accept Viva Health's Web Disclaimer.

We're here for you

If you have questions or complaints about your Viva Medicare plan or care that you have received, we want you to let us know right away.

You may also contact Medicare to file your complaint by clicking here and follow the instructions on the form. To find out information about the Medicare Ombudsman click here.

By clicking the links above you may be directed away from vivamedicaremember.com
© 2018 Viva Health, Inc. All Rights Reserved. Privacy Statement

Last updated 11/5/2018

Contact Us

Toll-free: 1-888-830-VIVA (8482)
TTY users, call: 711
Monday - Friday, 8am-8pm CST
Extended Office Hours:
(October 1 - February 14)
8am - 8pm CST Seven Days a Week


Disclaimers