Forms

Here you’ll find forms relating to your Medicare plan. If you have any questions, or if you’re unable to find what you’re looking for, contact us.

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Forms for Medicare plans

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  • Annual Enrollment Period Meeting

    Get answers to your Medicare questions! Learn how Medicare works and learn about HAP’s wide range of Medicare solutions.

  • Annual Enrollment Period Meeting

    Get answers to your Medicare questions! Learn how Medicare works and learn about HAP’s wide range of Medicare solutions.

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Copyright © 2017 HAP
2017 Health Alliance Plan of Michigan
Y0076_ALL 2018068 WEB 10.15 Pgs
Pending CMS Approval
Last Update 10/15/2017

HAP Senior Plus HMO, HMO-POS, and PPO are health plans with a Medicare contract. Enrollment in these plans depends on contract renewal. HAP Senior Plus PPO is a product of Alliance Health and Life Insurance Company, a wholly owned subsidiary of HAP. Alliance Medicare Supplement is a product of Alliance Health and Life Insurance Company, a wholly owned subsidiary of HAP.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

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  • HAP Medicare Sales:

    (877) 547-5186 (TTY:711)

  • (800) 868-3153 TTY: 711

    HAP Senior Plus®

    (800) 801-1770 TTY: 711

  • HAP Senior Plus®(PPO)

    (888) 658-2536 TTY: 711

  • Alliance Medicare Supplement:

    (800) 873-7526 TTY: 711