To join Passport Advantage, you must:

  • Have Kentucky Medicaid benefits;
  • Have Medicare Parts A and B benefits; and
  • Live in one of the following Kentucky counties: Jefferson, Bullitt, Hardin, or Nelson.


It’s easy to join!

To join, start by downloading our enrollment form:

2017 Plan or  2018 Plan

 

Send your completed form to:

Passport Advantage
5100 Commerce Crossings Drive
Louisville, KY 40229

If you are not a member and you have any questions or would like help completing the enrollment form, please call 1-844-643-2780;  Available from February 15 – September 30, Mon – Fri, 8 a.m. to 8 p.m. (EST) and  from October 1 to February 14, 7 days a week, 8 a.m. to 8 p.m. (EST).

NOTE: You will not be a member of Passport Advantage until Medicare approves your enrollment in Passport Advantage.


How do I get Medicare Part A or Part B?

You need Medicare Part A and Part B to join Passport Advantage. If you did not apply for Medicare Parts A or B during your initial enrollment period, you will have to apply in January, February, or March through your Social Security office. You may call 1-800-772-1213 to schedule an appointment.  It may take a few months for you to hear about your application. Kentucky Medicaid may pay your Medicare Part A or Part B premium if you meet certain requirements.

 


 

For multi-language interpreter services, click here.

 


Disenrollment Information

The form below can be used for disenrollment or you may submit a letter in writing with your signature. Mail the completed document to the location below. If you have questions, please contact member services at 1-844-859-6152 (TTY/TDD 711); available from February 15 – September 30, Mon – Fri, 8 a.m. to 8 p.m. (EST) and  from October 1 to February 14, 7 days a week, 8 a.m. to 8 p.m. (EST).

For the Member Disenrollment form, click here.

Send your completed form to:

Passport Advantage
5100 Commerce Crossings Drive
Louisville, KY 40229

 

Last Modified: November 8, 2017