If you are interested in learning more about Imperial Health Plan of California (HMO) (HMO SNP) please contact our prospective member toll-free line at: 1-800-838-5914.
Want to enroll in Imperial Health Plan, you can do so in one of the following ways:
- Enroll over the phone by calling us at 1-800-838-5648 and we will take your enrollment information over the phone
- Schedule a face-to-face appointment by calling 1-800-838-5914 and we can schedule an appointment with an employed Sales Representative or Independent Agent.
- Download the attached enrollment form and submit via:
Mail: Imperial Health Plan of California, Inc.
Attn: Membership Department
PO BOX 60874
Pasadena, CA 91116
- Complete online enrollment application via Medicare Online Enrollment Center (OEC) at http://www.medicare.gov. By accessing this link, you acknowledge that you have reviewed the Imperial Health Plan Summary of Benefits, Drug Formulary, and the Provider Search Function that are provided on https://www.imperialhealthplan.com or by calling the Membership Department at 1-800-626-380-9066.
2019 Enrollment Application
If you select PBP 005 Senior Value (HMO SNP), you must complete the SNP Assessment Form below.
- SNP Assessment Form – English Updated 12.12.18 [PDF,188KB]
- SNP Assessment Form – Spanish [PDF, 142KB]
- SNP Assessment Form – Chinese [PDF, 123KB]
Who can join?
To join any of our Plan Benefit Packages, you must meet all of the following requirements:
- You live in our service area
- You have both Medicare Part A and Medicare Part B
- You are a United States Citizen
- You do not have End-Stage Renal Disease (ESRD), with limited exceptions
To join Senior Value (HMO SNP), you must also have been diagnosed with diabetes, chronic heart failure (CHF), and/or cardiovascular disorders(s).