<
Adjust Page Text Size:
 

Call Center hours:

Mon through Fri - 8:00 a.m. to 8:00 p.m.

Local calls:
  • 330-363-7407
  • 1-800-577-5084
TTY / TDD users:
  • 330-363-7460
  • 1-800-617-7446
people jogging

Eligibility Information/Enrollment Forms

~ 2011 ~


To be eligibile for our HMO or PPO PLAN Options:
  • Must have Part A & B
  • Must reside in following counties
    • Stark
    • Carroll
    • Columbiana
    • Holmes
    • Harrison
    • Jefferson
    • Mahoning
    • Tuscarawas
    • Wayne
  • Only pre-existing ESRD not eligible to join PrimeTime Health Plan
2011 Enrollment Instructions and Forms

EFT Form

PPO

Enrollment Form Addendum

HMO




Medicare Online Enrollment

Medicare beneficiaries may enroll in PrimeTime Health Plan through the CMS Medicare Online Enrollment Center located through the following link:

Medicare Online Enrollment Center





Last Updated: 11/03/2010 9:34:00 AM
Special Communication Needs
If you or someone you know requires the assistance of a translator, please contact our Service Center at 330-363-7460 and we will gladly provide one for you. To access our TTY phone line, please dial 330-363-7460 or toll free at 1-800-617-7446 for the hearing impaired.
PrimeTime Health Plan
P. O. Box 6905 ; Canton, Ohio 44706
Copyright ;2006 PrimeTime Heath Plan		 Web Disclaimer

Contact Us		 CMS Approved 10292010
H3620H3664_102010WEB