Get H0609 028

The H0609 028 form, also known as the 2018 Enrollment Request Form, is essential for enrolling in a Medicare Advantage Plan offered by AARP MedicareComplete. This guide will provide you with detailed, step-by-step instructions for completing the form online, ensuring a smooth enrollment process.

Follow the steps to successfully complete the H0609 028 form online.

1. Click ‘Get Form’ button to obtain the H0609 028 form and open it in the online editor.
2. Fill in your personal information in the designated fields. Use black or blue ink if you are printing it, or type directly into the fields when filling out online. Include your last name, first name, middle initial, birth date, main phone number, and email address.
3. Indicate your gender by selecting 'Male' or 'Female' as required.
4. Provide your permanent residence address. Ensure your street address does not include a P.O. Box. Include your city, county, state, and ZIP code.
5. If your mailing address is different from your permanent residence, fill in the mailing address fields, using a P.O. Box if applicable.
6. In the section labeled 'Information about your Medicare,' enter the required details as they appear on your Medicare card. You can also attach a copy of your Medicare card if preferred.
7. Choose how you would like to pay your monthly plan premium. Options include payment by mail, online payment, automatic deductions from Social Security or Railroad Retirement Board checks, or direct payments from your bank account.
8. Answer the questions related to your Medicare and health insurance status, including whether you live in a nursing home, have other insurance, or need to provide information about your primary care provider.
9. Read through the agreement statements at the end of the form. Ensure you understand the commitments and conditions before signing.
10. Sign and date the form at the designated field. If you are signing as an authorized representative, ensure you complete the necessary information for the representative.
11. Once the form is fully completed, save your changes. You can then choose to download it, print it, or share it as needed.

Complete your H0609 028 form online for a hassle-free enrollment experience!