Provider Look-up Online Scheduling - HTA Insurance Services

Annual Enrollment Period

Medicare Advantage Provider Lookup

Scheduling Your Medicare Advantage Review

Complete the Provider Lookup Form below first.

Medicare Advantage plans use provider networks, so we need your doctor and preferred hospital information before scheduling your review.

After submitting the form, you’ll be redirected to our scheduling page where you can choose a convenient date and time for your appointment.

First Name (as on Medicare ID Card)(Required)

Last Name(Required)

Email Address(Required)

Name of your Preferred Hospital(Required)

Location-City, State(Required)

Your Provider Information

Medicare Advantage plans use provider networks. Please list your doctors and other healthcare providers so we can check which plans include them.

Do you have a Primary Care Doctor(Required)

Yes

Primary Care Doctor(Required)

Are you willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

How Many Additional Doctors Do You Currently See?(Required)

Doctor 1(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 2(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 3(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 4(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 5(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 6(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 7(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 8(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Would you like to provide Doctor information for a SPOUSE/PARTNER (if applicable)?(Required)

Yes

SPOUSE/PARTNER'S Doctor Info

Medicare Advantage Plans are network based plans. We will need a list of all of your doctors to find the most appropriate solutions.

Does your spouse/partner have a Primary Care Doctor(Required)

Yes-Different than mine

Yes-Same as mine

Primary Care Doctor sp(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

SPOUSE/PARTNER-How Many Additional Doctors Do You Currently See?(Required)

Doctor 1 sp(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 2 sp(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 3 sp(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 4 sp(Required)

Specialty(Required)

Willing to change provders?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 5 sp(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 6 sp(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 7 sp(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Doctor 8 sp(Required)

Specialty(Required)

Willing to change providers?(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Annual Enrollment Period

Medicare Advantage Provider Lookup

Scheduling Your Medicare Advantage Review

Your Provider Information

SPOUSE/PARTNER'S Doctor Info

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