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Blue shield 65 plus disenrollment form2018 San Bernardino County Retiree Benefits Goodbye SHIELD 65 PLU SSM (HMO), BLUE SHIELD 65 PLUS CHOICE PLAN (HMO) & BLUE SHIELD TRIO MEDICARE (HMO) DISENROLLMENT

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How to fill out blue shield 65 plussm

01

To fill out Blue Shield 65 PlusSM, follow these steps:

02

- Begin by gathering all necessary personal information, such as your name, date of birth, and address.

03

- Obtain the Blue Shield 65 PlusSM application form either online or by contacting Blue Shield directly.

04

- Fill out the application form thoroughly and accurately. Provide all required information, including your medical history, current medications, and any pre-existing conditions.

05

- Make sure to review the completed form for any errors or missing information. Correct any mistakes before submitting the application.

06

- Submit the filled-out application form to Blue Shield through the designated method, such as online submission or mailing it to their specified address.

07

- Wait for a confirmation from Blue Shield regarding the status of your application. This may include additional requests for information or documents if necessary.

08

- Once your application is approved, you will receive your Blue Shield 65 PlusSM coverage details and membership materials. Keep these documents in a secure place for future reference.

Who needs blue shield 65 plussm?

01

Blue Shield 65 PlusSM is designed for individuals who meet specific criteria:

02

- You must be aged 65 or older.

03

- You can't be enrolled in both Medicare Part A and B.

04

- You must reside in California and have a valid California address.

05

- You may have certain chronic conditions, special needs, or qualify for Medicare due to a disability.

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