Medicare Advantage Members

Forms + Resources


To access the Quartz Medicare Advantage enrollment application, please visit the enrollment page.

Plan Benefit Selection Form

To change plans, please complete the following form:

Standard Print | Large Print | Spanish​​​


Sign up for MyChart to get secure, online access to your account for billing, benefits, and claims. Use the Find a Doctor Tool to find the nationally-ranked care you deserve.

Other Forms

Completed forms can be mailed or faxed to:

Quartz Medicare Advantage (HMO)
840 Carolina Street
Sauk City, WI 53583

Fax: (608) 881-8396

Contact Us

Quartz is committed to providing superior customer service. That's one reason we offer so many ways to reach us.