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Enroll Now!

When Can I Enroll?

You have several options for enrollment

Option 1

Have Liberty Health Advantage contact you.

Option 2

Download and complete an application and send it to us via mail or fax.
2011 Enrollment Form
2011 Inscripción
2012 Enrollment Form
2012 Inscripción
Application Instructions
Instrucciones Para Inscripción

Option 3

Enroll Online Now
Option 4

Enroll online with 1-800-MEDICARE's Online Enrollment Center.

Option 5

Speak to a Liberty Representative live right now Click to Call.

Let us

Contact You
Enroll Now
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Need Help?

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Contact Information

Member Services

  • 1-866-542-4269
  • 1-800-662-1220 TTY
  • Monday through Sunday
  • 8:00 a.m. to 8:00 p.m.

Enrollment Representative

  • 1-866-542-4269
  • 1-800-662-1220 TTY
  • Monday through Sunday
  • 8:00 a.m. to 8:00 p.m.

Enrollment

Download a 2011 Enrollment Form

Download a 2012 Enrollment Form

You may download, complete, sign and date an enrollment form. Application Instructions

Once you have completed the form please fax it to:

1-631-227-3484

Or mail it to:

Liberty Health Advantage
1 Huntington Quadrangle
Suite 3N01
Melville, NY 11747

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Copyright © 2011. All Rights Reserved.

Liberty Health Advantage HMO is a Coordinated Care Plan with a Medicare Advantage contract and a contract with the New York State Medicaid program.

H3337_LHA_MARK_1227 CMS Approved 11/03/2011

Last Modified: Wed, October 05, 2011 19:04:23