Get the free 0938-1378 Expires: 12/31/2026

OMB No. 09381378 Expires: 12/31/2026Reminders:If you want to join a plan during fall open enrollment (October 15December 7), the plan must get your completed form by December 7. If you want to join

How to fill out 0938-1378 expires 12312026

How to fill out 0938-1378 expires 12312026

1. Begin by downloading the 0938-1378 form from the official CMS website.
2. Fill in your personal information at the top of the form, including your name, address, and Social Security number.
3. Indicate your Medicare information, if applicable, including your Medicare number.
4. Provide information about your current health coverage and any gaps in coverage.
5. Complete any additional sections that pertain to your specific situation, such as income or household information.
6. Review the form for accuracy and completeness to ensure all required fields are filled.
7. Sign and date the form as required.
8. Submit the form via the specified method, whether by mail or online, ensuring you keep a copy for your records.

Who needs 0938-1378 expires 12312026?

1. Individuals applying for or updating their Medicare coverage.
2. People looking to report changes in their health insurance status.
3. Anyone who needs to enroll in Medicare for the first time.
4. Current Medicare beneficiaries who are making changes to their coverage.

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What is 0938-1378 expires 12312026?

Form 0938-1378 is a Medicare health plan enrollment form used by beneficiaries to enroll in or switch Medicare Advantage plans. The expiration date indicates that the current version of the form is valid until December 31, 2026.

Who is required to file 0938-1378 expires 12312026?

Individuals who are eligible for Medicare and wish to enroll in a Medicare Advantage plan or make changes to their current plan are required to file Form 0938-1378.

How to fill out 0938-1378 expires 12312026?

To fill out Form 0938-1378, individuals must provide personal information such as their name, address, Medicare number, and plan choices. It is important to follow the instructions provided on the form carefully to ensure all required fields are completed.

What is the purpose of 0938-1378 expires 12312026?

The purpose of Form 0938-1378 is to facilitate the enrollment process for Medicare beneficiaries into Medicare Advantage plans, allowing them to choose their preferred coverage options.

What information must be reported on 0938-1378 expires 12312026?

The information that must be reported on Form 0938-1378 includes the beneficiary's personal details (name, address, Medicare number), their health plan selection, any relevant prior coverage information, and signatures confirming the information provided.