Documents and Materials
EFFECTIVE 03/01/2024 - 02/28/2025 MEDICARE SUPPLEMENT PLAN MATERIALS
- Application for a Medicare Supplement Policy (PDF)
- 2024 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)
- 2024 Medicare Supplement Guaranteed Issue Guide (PDF)
- Medicare Supplement Replacement of Coverage (PDF)
- Optional Standard PPO Dental Brochure (PDF)
- Optional Standard PPO Dental Plan Application (PDF)
- Healthy Discount Booklet (PDF)
- Acupuncture and Chiropractic (PDF)