3. Mail
Start by downloading the appropriate application below:
2023 Capital District/Southern Tier/Central New York Region Application (PDF)
(Albany, Allegany, Broome, Cattaraugus, Cayuga, Chautauqua, Chemung, Chenango, Columbia, Cortland, Delaware, Dutchess, Fulton, Greene, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Onondaga, Orange, Oswego, Otsego, Putnam, Rensselaer, Rockland, Saratoga, Schenectady, Schoharie, Schuyler, Steuben, Sullivan, Tioga, Tompkins, Ulster, Warren, Washington, and Westchester counties)
2023 Hudson Valley Region Application (PDF)
(Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester counties)
2023 Rochester / Buffalo Region Application (PDF)
(Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans, Seneca, Wayne, Wyoming and Yates counties)
2023 MVP DualAccess HMO D-SNP Application (PDF)
(Albany, Columbia, Dutchess, Greene, Monroe, Orange, Putnam, Rensselaer, Rockland, Saratoga, Schenectady, Sullivan, Ulster, and Westchester counties)
2023 Vermont/Northern New York (PDF)
(Addison, Bennington, Caledonia, Chittenden, Essex, Franklin, Grand Isle, Lamoille, Orange, Orleans, Rutland, Washington, Windham, and Windsor counties in Vermont; Clinton, Essex, Franklin, Hamilton, and St. Lawrence counties in New York)
Once you’ve downloaded the application, follow these simple instructions:
- Select your plan choice on the application.
- Be sure to fill out one application for each person enrolling.
- Sign and date the application(s).
- Send your completed application(s) to:MVP Health Care
MVP Medicare Enrollment
MVP Health Care
220 Alexander St.
Rochester, NY 14607
