Please print, complete, and mail an application form. Send your application form to the following address:
Community Health Plan of Washington
ATTN: CHPW Medicare Advantage
1111 Third Avenue, Suite 400
Seattle, WA 98101
Use the following forms to enroll in one of our Medicare Advantage Plans:
2021 Enrollment Forms
➞ Application Form
➞ Formulario de Inscripción Individual
2020 Enrollment Forms