Touchstone Health

Enrollment Forms (English)

Standard Enrollment Form
Disclaimer: This material was created prior to a service area reduction and plan termination. The Touchstone Health Medicare Clear Plan is no longer offered by Touchstone Health. Touchstone Health HMO is no longer available in Broome, Chenango, Delaware or Onondaga counties in New York.
Short Enrollment Form
Online Medicaid Advantage Enrollment Form (for Enrollment in Touchstone Health Prestige Plan)
Printable Medicaid Advantage Enrollment Form (for Enrollment in Touchstone Health Prestige Plan)

Standard Enrollment Form
Disclaimer: This material was created prior to a service area reduction and plan termination. The Touchstone Health Medicare Clear Plan is no longer offered by Touchstone Health. Touchstone Health HMO is no longer available in Broome, Chenango, Delaware or Onondaga counties in New York.
Short Enrollment Form
Medicaid Advantage Enrollment Form (for Enrollment in Touchstone Health Prestige Plan)

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