CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental Hospital Medical and Surgical Benefits Claim Form 2013 free printable template

ILIUM COASTLINE CLAIMS OFFICE WELFARE PLAN Medicare Supplemental Hospital, Medical, and Surgical Benefits Claim Form (For Retirees, their Dependents or Survivors Enrolled Under Part A and Part B of

How to fill out CA ILWU-PMA Coastwise Indemnity Plan Medicare

How to fill out CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental

1. Obtain the CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental application form from the official website or your local union office.
2. Fill out the personal information section, including your name, address, date of birth, and Medicare number.
3. Provide details about your current Medicare coverage and any other health insurance plans you may have.
4. Complete the beneficiary designation section, if applicable, to indicate who should receive benefits in the event of your passing.
5. Review the terms and conditions of the plan carefully, ensuring you understand the coverage provided.
6. Sign and date the application form to certify that the information provided is accurate.
7. Submit the completed application form either by mail or electronically as instructed on the form.

Who needs CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental?

1. Retired or active members of the ILWU-PMA who are eligible for Medicare.
2. Individuals who want additional coverage to supplement their Medicare benefits.
3. Those seeking to cover out-of-pocket costs associated with Medicare, including copayments and deductibles.
4. People who rely on medical services frequently and want to ensure comprehensive coverage.

People Also Ask about

What insurance is ILWU?

ILWU-PMA Benefit Plans administers healthcare and pension benefits to the active and retired longshore workers of the West Coast, as well as their dependents and survivors.

What is the phone number for Coastwise claims provider?

For the latest Schedule of Allowances, contact your Local or the Benefit Plans office, or call the Claims Office at (415) 543-0114 or (800) 955-7376.

What is the ILWU PMA Coastwise indemnity plan?

The ILWU-PMA Coastwise Indemnity Plan is a self-funded indemnity plan, which allows you to obtain services from any licensed doctor or hospital. Benefits are paid ing to a Schedule of Allowances under Basic Benefits and under Major Medical.

What is the ILWU pension plan in San Francisco?

ILWU-PMA Pension Plan is a non-contributory defined benefit union pension fund based in San Francisco, California. Established in 1951, the plan provides retirement coverage for the participants of the plan and their eligible beneficiaries.

What are the health benefits of ILWU?

Plan participants have full access to a wide range of health care benefits. For instance, the plan provides hospital, medical and surgical care, prescription drugs, dental and vision care, hearing aids, substance abuse recovery programs and disability benefits.

What is the ILWU-PMA Coastwise indemnity Plan?

The ILWU-PMA Coastwise Indemnity Plan is a self-funded indemnity plan, which allows you to obtain services from any licensed doctor or hospital. Benefits are paid ing to a Schedule of Allowances under Basic Benefits and under Major Medical.

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What is CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental?

The CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental is a health insurance plan designed to provide additional coverage for Medicare beneficiaries associated with the International Longshore and Warehouse Union (ILWU) and Pacific Maritime Association (PMA). It helps cover costs that Medicare does not fully pay, such as deductibles, copayments, and certain services.

Who is required to file CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental?

Eligible members of the ILWU and their dependents who are enrolled in Medicare may be required to file for the CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental to ensure they receive the additional benefits provided by the plan.

How to fill out CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental?

To fill out the CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental, members should gather all required information such as personal details, Medicare information, and relevant medical expenses. They can then complete the application form provided by the plan and submit it along with any necessary documentation as instructed.

What is the purpose of CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental?

The purpose of the CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental is to offer additional financial protection to ILWU members by covering health care costs not paid by Medicare. It aims to reduce out-of-pocket expenses for medical services and ensure better access to health care.

What information must be reported on CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental?

The information that must be reported on the CA ILWU-PMA Coastwise Indemnity Plan Medicare Supplemental includes personal identification details, Medicare number, coverage dates, medical treatment information, and any other relevant medical expenses that may require reimbursement.