Alliance Medicare Supplement
- Please read the application form carefully.
- Answer the questions completely.
- Eligible Medicare beneficiaries reside in the state of Michigan.
- Submitting your application through the online process constitutes a valid request on your part to purchase an Alliance Medicare Supplement policy. In the event of an omission on the application form, you will be contacted by a Health Alliance Plan representative.
- If you lost or are losing other health insurance coverage and received a notice from your prior insurer saying you were eligible for guaranteed issue of a Medicare supplement insurance policy, forward a copy of the notice.
HAP MEDICARE SOLUTIONS
HEALTH ALLIANCE PLAN
21700 NORTHWESTERN HWY STE 401
SOUTHFIELD, MI 48075-9841