top of page
Document with Pen

FORMS

PRE 65 Brochures, Enrollment Information & Forms

Pre 65 Forms & Brochures

Sunset of the Health Coverage Tax Credit

To date, the Health Coverage Tax Credit (HCTC) has not been extended and funding continues to not be available.

POST 65 Brochures, Enrollment Information & Forms

Medicare Forms & Brochures

2025 Forms and Brochures

 

1.)  Please review the Formulary provided below.

2.)  The BCBS Medicare Advantage Plans INCLUDE a Prescription Drug Plan.  Please review the Benefit at a Glance Document for all 3 plans to determine what fits your needs if you are interested in a Medicare Advantage Plan.

3.)   The Hartford Supplemental Plans can be elected with a BCBS High or Low Prescription Drug Plan.  

4.)  You can enroll in one of the Standalone Prescription Drug Plans that are offered through BCBS.  (You are not allowed to enroll in the Standalone Prescription Drug Plan if you are enrolled in a different Medicare Advantage Plan)

 

If enrolling in The Hartford Plan(s), The Hartford and Medicare Enrollment Forms must be completed and submitted at the same time.

airline button.jpg
auto button.jpg
steel button.jpg

have

questions?

      Call Us!

(844)428.2669

bottom of page