Elevate Medicare Advantage Enrollment Form | Denver Health Medical Plan

Members should complete both the Enrollment form and Attestation form when completing a paper application.

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2025 Medicare Advantage Enrollment Form - English245.36 KB2025 Medicare Advantage Enrollment Form - Spanish280.52 KB2024 Medicare Advantage Enrollment Form - English453.48 KB2024 Medicare Advantage Enrollment Form - Spanish299.6 KB2024 Medicare Enrollment Eligibility Attestation Form - English175.13 KB2024 Medicare Enrollment Eligibility Attestation Form - Spanish186.17 KB