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This document serves as an application for seniors aged 65 and older to enroll in Anthem Blue Cross and Blue Shield coverage options.

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How to fill out Anthem Extras Packages Senior Enrollment Application

01

Begin by gathering personal information: name, address, phone number, and date of birth.

02

Provide your Medicare information, including Medicare Number and effective date.

03

Indicate your preferred method of communication (mail, phone, or email).

04

Review the plan options available and select your desired Anthem Extras Package.

05

Fill out the health history section, answering all questions truthfully.

06

Sign and date the application to confirm that all information is correct.

07

Submit the application either online, by mail, or fax as instructed.

Who needs Anthem Extras Packages Senior Enrollment Application?

01

Seniors who are eligible for Medicare and looking for additional benefits not covered by their Medicare plans.

02

Individuals seeking supplemental coverage to help with healthcare costs, such as vision, dental, and wellness services.

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What is Anthem Extras Packages Senior Enrollment Application?

The Anthem Extras Packages Senior Enrollment Application is a form used by seniors to enroll in additional services and benefits offered by Anthem, which may enhance their healthcare coverage.

Who is required to file Anthem Extras Packages Senior Enrollment Application?

Seniors who wish to enroll in the Anthem Extras Packages and take advantage of the enhanced benefits are required to file the application.

How to fill out Anthem Extras Packages Senior Enrollment Application?

To fill out the application, seniors should provide their personal information, insurance details, and select the specific benefits they wish to enroll in, following the instructions included with the application form.

What is the purpose of Anthem Extras Packages Senior Enrollment Application?

The purpose of the application is to facilitate the enrollment of seniors in additional services that can improve their health care experience and access to necessary resources.

What information must be reported on Anthem Extras Packages Senior Enrollment Application?

The application requires personal identification details, insurance policy numbers, contact information, and preferences regarding the additional benefits.

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