Enroll in a Plan | Ascension Complete Indiana
Enroll in a Plan in Indiana
Thank you for your interest in becoming a member of Ascension Complete. We are excited for you to join us!
There are three (3) ways to enroll:
Call us and one of our licensed sales and enrollment representatives will help you through the enrollment process.
1-844 578-1927; (TTY: 711)
By Mail Or Fax
Download and print your enrollment application. Once you fill it out, mail it or fax it to us. If you need help, contact Member Services to speak to a licensed sales agent.
Paper Application Instructions
- Download and print the paper application.
- Please fill out the paper application.
- Enter your Primary Care Physician's name.
- Sign and date the enrollment application.
- Check any box on page 9 that applies to you.
- Submit your application via mail or fax.
Mail Your Application
Send your application to:
PO Box 10420
Van Nuys, CA 91499-6208
Fax Your Application
Fax your application to: