Get Aarp 2011 Medicare Supplement Application.pdf

This guide provides step-by-step instructions for filling out the AARP 2011 Medicare Supplement Application online. Whether you are a new applicant or renewing your coverage, this comprehensive resource will ensure that you complete your application accurately and efficiently.

Follow the steps to fill out your application successfully.

1. Click the ‘Get Form’ button to access the application. Once you have obtained the form, open it in the online editor.
2. Begin by entering your AARP Membership Number if applicable. If you are not a member, ensure to complete the AARP Membership Form as well.
3. Fill in your personal details, such as your first name, middle initial, and last name. Clearly print your address, city, state, and zip code.
4. Provide your birth date and Medicare information, including your Medicare claim number, effective dates for Part A and Part B, and your contact information.
5. Indicate your tobacco usage by marking the appropriate circle for whether you have smoked or used any tobacco products in the past twelve months.
6. Select the Medicare supplement plan you wish to enroll in (e.g., Plan A, B, C, etc.) and provide the desired coverage effective date.
7. Answer the questions related to your guaranteed acceptance status based on your age and enrollment in Medicare Part B.
8. Complete the health questions section. Answer truthfully regarding any past medical conditions to determine your eligibility for coverage.
9. Provide information about any past or current health coverage, including details on Medicare Advantage plans if applicable.
10. Sign and date the application in all the indicated areas. Ensure any agent assisting you also signs where required.
11. If you are opting for automatic payments, complete the Automatic Payments Authorization Form and include a voided check.
12. Finally, review all filled-in fields for accuracy, then save your changes. You can download, print, or share the completed form as needed.

Complete your AARP 2011 Medicare Supplement Application online today to ensure timely processing and coverage.