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Health Insurance Application Please be sure to complete ALL information below to avoid delays in processing and refer to page 3 of the Plan 65 Sales Brochure for eligibility information. Please type

How to fill out plan 65 application

How to fill out the Plan 65 application:

1. Gather necessary documents: Before filling out the Plan 65 application, make sure to have all the required documents ready. These may include identification proof, income verification, and any supporting documents specific to your eligibility.
2. Start with personal information: Begin by providing your personal details accurately in the appropriate sections of the application. This typically includes your full name, date of birth, address, phone number, and email address.
3. Provide necessary medical information: The Plan 65 application may require you to disclose information about your medical history and any pre-existing conditions. Make sure to answer these questions truthfully and provide the requested details to the best of your knowledge.
4. Fill out income details: In this section, you might need to provide information about your income sources, such as wages, pensions, or social security benefits. It is important to accurately document your income to determine your eligibility for Plan 65.
5. Include any additional information: If there are any additional details or circumstances that may affect your application, make sure to include them in the designated section. This can include information regarding life changes, special circumstances, or any supporting documentation that could strengthen your application.
6. Review and submit the application: After completing all the required sections, thoroughly review your application to ensure all the information provided is accurate and up to date. Double-check for any errors or missing information. Once confident, go ahead and submit your completed Plan 65 application.

Who needs Plan 65 application?

1. Individuals approaching Medicare eligibility: Plan 65 is a Medicare Supplement Insurance plan available for individuals who are about to be eligible for Medicare. Therefore, anyone who is nearing the age of 65 and wants additional coverage beyond what Original Medicare provides should consider filling out a Plan 65 application.
2. Medicare beneficiaries seeking additional coverage: Certain Medicare beneficiaries might find that their current coverage does not fulfill all their healthcare needs. In such cases, filling out the Plan 65 application can help them apply for supplemental insurance to cover the gaps in their healthcare coverage.
3. Those wanting more comprehensive coverage: While Original Medicare offers basic coverage for healthcare expenses, it may not cover everything. If you are looking for a wider range of coverage, including services like prescription drugs, dental or vision care, then filling out a Plan 65 application may be beneficial.

Note: It is important to consult with a certified insurance agent or Medicare advisor to determine if Plan 65 is the right fit for your healthcare needs and to fully understand the eligibility criteria and coverage options available to you.

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