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Individual Enrollment Request Form to Enroll in a Medicare Advantage Plan (Part C) Who can use this form?OMB No. 09381378 Expires: 7/31/2024Reminders: If you want to join a plan during fall open enrollment
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What is between October 15 and December 7?
Between October 15 and December 7, individuals can enroll in, change, or drop Medicare plans, including Medicare Advantage and Medicare Part D.
Who is required to file between October 15 and December 7?
Individuals eligible for Medicare and those who want to make changes to their Medicare Advantage or Part D coverage are required to file during this period.
How to fill out between October 15 and December 7?
To fill out forms during this period, individuals need to review their current Medicare plans, compare available options, and submit changes or new applications online, via phone, or through a paper form.
What is the purpose of between October 15 and December 7?
The purpose of this period is to provide beneficiaries with an opportunity to review and adjust their Medicare health and prescription drug plans for the upcoming year.
What information must be reported on between October 15 and December 7?
Individuals must report any changes in their health status, prescription medications, and any other relevant information that may affect their Medicare coverage needs.
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