Medicare & Health Insurance Forms

Medicare Forms

Medicare Part B Application Enrollment

Medicare Request for Employment Information

Medicare Part B Monthly Payment EFT Form

Waive Medicare Part A or B Premiums

Medicare Part D Premiums

Scope of Appointment

Part D Costs

Scope of Appointment Form

Customer Service Phone Numbers

AARP/United Healthcare: (800) 721-0627

Ameritas: (800) 300-9566

Blue Cross Blue Shield MN: (800) 382-2000

Delta Dental MN: (800) 448-3815

GeoBlue-BCBS: (888) 412-6403

HealthSpring: (866) 459-4272

Humana: (800) 281-6918

IMG (International Medical Group): (800) 628-466

Medica: (866) 269-6804

MNsure: (855) 366-7873

Mutual of Omaha: (800) 228-7104

Silver Script: (866) 362-6212

Spirit Dental: (844) 833-8440

Wellcare: (888) 550-5252