HAP has moved from its Southfield location. Effective November 26, 2018, our new address is 1414 E. Maple in Troy

Important forms and documents

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.

Please note: All of these documents require Adobe Reader to download. Download Adobe Reader for free.

Forms for Medicare plans

Please choose the type of form you need from the following list.

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  • Medicare 101 Seminar

    Get real answers to all your questions! We’ll teach you about how Medicare works and give you tips and ideas to make sure you’re ready to go on day

  • Medicare 101 Seminar

    Get real answers to all your questions! We’ll teach you about how Medicare works and give you tips and ideas to make sure you’re ready to go on day

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Copyright © 2018 HAP
2018 Health Alliance Plan of Michigan
Y0076_2019 HAP Website
CMS Accepted 10/1/2018

HAP Senior Plus (HMO)/(HMO-POS)/(PPO) and HAP Primary Choice Medicare (HMO) are health plans with Medicare contracts. HAP Empowered Duals (HMO SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment in the plans depends on contract renewals. HAP Senior Plus (PPO) 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. For more information call Medicare Michigan customer service at (800) 868-9885 (TTY: 711) 8 a.m. to 8 p.m., seven days a week (Oct. 1 – March 31) / 8 a.m. to 8 p.m., Monday through Friday (April 1 - Sept. 30).

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  • HAP Medicare Sales:

    (800) 868-9885 (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)