Documents and Materials
EFFECTIVE 3/1/2022 - 2/28/2023 MEDICARE SUPPLEMENT PLAN MATERIALS
- Application for a Medicare Supplement Policy (PDF)
- Outline of Coverage (PDF)
- Automatic Bank Draft Form (PDF)
- Disenrollment Form (PDF)
- Health Net Medigap Plans Pre-Enrollment Guide (PDF)
- Choosing a Medigap Policy (PDF)
- Medicare Supplement Guaranteed Issue Guide (PDF)
- Combined Acupuncture and Chiropractic Care (PDF)
- Medicare Supplement Replacement of Coverage (PDF)
- The Silver&Fit® Healthy Aging and Exercise Program (PDF)
- Decision Power Healthy Discounts (PDF)
- Optional Standard PPO Dental Brochure (PDF)
- Optional Standard PPO Dental Plan Application (PDF)
Last updated: 2/22/22