Fill out the form below to get more information about our Medicare Advantage plan offered in Utah.

 

Please enable JavaScript in your browser to complete this form.
Authorized Representative Name
Address
Beneficiary's Name
Clear Signature
Checkboxes

I understand an agent may contact me. American Health Advantage of Utah, offered by American Health Plan of Utah, Inc, is a Health Maintenance Organization (HMO) with a Medicare Contract. Enrollment in American Health Advantage of Utah depends on contract renewal. This plan is available to Medicare recipients who reside in a contracted nursing home or live at home and Utah has certified that you need the type of care that is usually provided in a nursing home.

Y0144_PRMCNTCRD_C