to main content

Pay My Bill

Set Up Your Premium Payment

KelseyCare Advantage offers three convenient methods to pay your monthly premium. Simply download the form below that best suits your needs, then send the completed form to us by mail, email, or fax. You will receive a confirmation by phone or email each time your payment is received.

Electronic Funds Transfer (EFT)

To pay your plan premium by Electronic Funds Transfer (EFT) each month, download, complete, and return the form below. Your monthly plan premium will be automatically withdrawn from your bank account.

Social Security Benefit Deduction

To pay your plan premium by deduction from your Social Security Benefit, download, complete, and return the form below. Once the form is received, KelseyCare Advantage will submit the premium withhold request on your behalf to your selected Benefit Administrator for the next available effective date.

Railroad Retirement Benefit Deduction

To pay your plan premium by deduction from your Railroad Retirement Benefit, download, complete, and return the form below. Once the form is received, KelseyCare Advantage will submit the premium withhold request on your behalf to your selected Benefit Administrator for the next available effective date.

Where to Send Your Form

MAIL:

KelseyCare Advantage
ATTN: Enrollment
P.O. Box 841569
Pearland, TX 77584

FAX: 713-442-9536

Email: KCAPA@kelsey-seybold.com

Need Additional Support?

Reach out to a KelseyCare Advantage Member Services specialist by calling 713-442-CARE (2273), option 2, or toll-free at 1-866-535-8343 (TTY:711).

  • October 1 - March 31, 8 a.m. to 8 p.m., seven days a week
  • April 1 - September 30, 8 a.m. to 8 p.m., Monday through Friday
X
Cookies help us improve your website experience.
By using our website, you agree to our use of cookies.
Confirm