To speak with a licensed agent call 1-844-324-0691 (TTY 711)

Member Enrollment


Please fill out these fields to complete your enrollment.
All fields marked with * are required.

Paying Your Plan Premium

If we determine that you owe a late enrollment penalty (or if you currently have a late enrollment penalty), we need to know how you would prefer to pay it.

You can pay your monthly plan premium (including any late enrollment penalty that you currently have or may owe) by mail, “Electronic Funds Transfer (EFT)”, credit card each month. You can also choose to pay your premium by automatic deduction from your Social Security or Railroad Retirement Board (RRB) benefit check each month. If you are assessed a Part D-Income related Monthly Adjustment Amount, you will be notified by the Social Security Administration. You will be responsible for paying this extra amount in addition to your plan premium. You will either have the amount withheld from your Social Security benefit check or be billed directly by Medicare or the RRB. DO NOT pay Vibra Health Plan the Part D-IRMAA.

People with limited incomes may qualify for extra help to pay for their prescription drug costs. If eligible, Medicare could pay for 75% or more of your drug costs including monthly prescription drug premiums, annual deductibles and co-insurance. Additionally, those who qualify will not be subject the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this extra help, contact your local Social Security offices or call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. You can also apply for extra help online at www.socialsecurity.gov/prescriptionhelp.

If you qualify for extra help with your Medicare prescription drug coverage costs, Medicare will pay all or part of your plan premium. If Medicare pays only a portion of this premium, we will bill you for the amount that Medicare doesn’t cover.

If you don’t select a payment option, you will get a bill each month.

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(The Social Security/RRB deduction may take two or more months to begin after Social Security or RRB approves the deduction. In most cases, if Social Security or RRB accepts your request for automatic deduction, the first deduction from your Social Security or RRB benefit check will include all premiums due from your enrollment effective date up to the point withholding begins. If Social Security or RRB does not approve your request for automatic deduction, we will send you a paper bill for your monthly premiums.)

NOTE: Other payment options offered are: Credit Card payments and Electronic funds transfer (EFT). To enroll in these options, after your enrollment application has been approved, please contact Vibra Health Plan at 1-844-388-8268 (TTY users should call 711). We are open seven (7) days a week 8 A.M to 8 P.M. You can also visit Vibra Health Plan’s member portal to sign-up. Further details will follow in your Member Welcome Kit. We will send you a paper bill for your monthly premiums until the Credit Card or EFT option is effective.

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We want to make sure that you know you are exiting our site and going to an external website.

Tell us where you live.

Medicare beneficiaries may also enroll in Vibra Health Plan through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov.

To view your coverage options, enter your zip code and county below.

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We're sorry, but you have either entered an incorrect zip code or you are out of our service area.

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Vibra Health Plan is a PPO with a Medicare contract. Enrollment in Vibra Health Plan depends on contract renewal.

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Before you enroll

To make sure you are eligible we'll need a few more pieces of information.

Before your enroll

You must have Medicare Part A and Part B to join a Medicare Advantage Plan.

Generally you are not eligible to enroll in our plan if you have been medically determined to have ESRD. If you have had a successful kidney transplant and/or you don’t need regular dialysis any more, you are eligible to enroll, we will need to contact you to obtain additional information.

Are you new to Medicare?

Are you already entitled to Part A and enrolled in Part B?

Do you have end-stage renal disease ESRD?

If you have had a successful kidney transplant and/or you don't need regular dialysis any more, please mail a note or records from your doctor showing you have had a successful kidney transplant or you don't need dialysis, otherwise we may need to contact you to obtain additional information.

Vibra Health Plan, Inc.

4000 Crums Mill Rd.

Suite 201

Harrisburg, PA 17112
To speak with a licensed agent call 1-844-324-0691 (TTY 711)

8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)

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View Plan Options

Please select one of our coverage options below.

Your options
Plan Monthly Premium Primary Care Copay Out-of-pocket Max Select
$0In $10 | Out $35$6,700
$49.50In $5 | Out $25$4,800

Do you want to add optional dental coverage?

Your monthly rate will increase by $33.30.

For more details pertaining to the optional dental benefits, please see the Summary of Benefits.

Your monthly rate will increase by $28.00.

For more details pertaining to the optional dental benefits, please see the Summary of Benefits.

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Ready to Enroll?

It looks like you are interested in the plan outlined below. By clicking the “Enroll Now” button, you are confirming your intent to complete an actual enrollment request to join Vibra Health Plan.

You will want to have your Medicare card available to help complete the application.

If you need assistance during this process, our contact information is listed below.

Plan Breakdown

  • Primary Care Copay In $10 | Out $35
  • Out-of-pocket Max $6,700

Estimated monthly payment:

  • Monthly Premium $0
  • Monthly Dental Premium (Optional) $33.30

  • Monthly Total ${[{ mec.formatMonthlyTotal('Essential_Coverage_PPO') }]}
  • Primary Care Copay In $5 | Out $25
  • Out-of-pocket Max $4,800
  • Monthly Premium $49.50
  • Monthly Dental Premium (Optional) $28.00

  • Monthly Total ${[{ mec.formatMonthlyTotal('Enhanced_Coverage_PPO') }]}
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Important Information

You may enroll in only one Medicare Advantage Plan at a time.

You may join or leave that plan only at certain times of the year or in special circumstances.

The Annual Election Period occurs October 15 through December 7. During this time, eligible individuals may enroll in or change Medicare Advantage Plans. Coverage will begin January 1.

Other Enrollment Methods

Fax: 1-844-260-7923
For Phone Applications (please call to speak with a licensed agent)
Phone: 1-844-324-0691 (TTY 711)
Phone: 1-800-MEDICARE (1-800-633-4227)
Hours: 8 am - 8 pm Mon - Fri (Mon - Sun from 10/15/16 to 2/14/17)
Online: Medicare beneficiaries may also enroll in Vibra Health Plan through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

Note

You must continue to pay your Medicare Part B premium.

Vibra Health Plan is a PPO with a Medicare contract. Enrollment in Vibra Health Plan depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.


Last Updated Nov. 11th, 2016 (H9408_17_49134_Webenroll Approved)