Name of provider (printed). "MA Plan" shall mean a qualified Medicare Advantage organization offering MA Programs through an MA Contract.There are 2 main ways to get Medicare: • Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical. Insurance). This subpart sets forth application requirements for entities seeking a contract as a Medicare organization offering an MA plan. You may fill out the contracting application online; however, you must print and fax it to . There are 2 main ways to get Medicare: • Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical. Insurance). This subpart sets forth application requirements for entities seeking a contract as a Medicare organization offering an MA plan. MA Medicaid Number: MA Medicare Number: Secondary Specialty: Applying as: ☐ PCP ☐ Specialist ☐ Hospitalist ☐ Other. Opting out of Medicare allows a physician or practitioner to render services to Medicare-enrolled beneficiaries under a private contract. In the last 6 months, how often did your health plan's customer service give you the information or help you needed?