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Click ‘Get Form’ to open the Senior Service Medical Plan enrollment form in the editor.
Begin by filling out your personal information in the Volunteer Information section. Include your name, Social Security number, and birth date. Make sure to select your marital status and gender.
Next, move to the Assignment Information section. Indicate your assignment sponsor and provide details about your mission or entity name, assignment location, and effective dates for coverage.
In the Mailing, Email Address, & Telephone Information section, enter your current mailing address along with contact details for during and after your mission.
Complete the Contact Person Information section by providing a trustworthy individual’s contact details who can be reached during your service.
Review the Post-Mission Transitional Coverage Information and mark your choice regarding this coverage option. Initial where indicated.
Finally, read through the Terms & Conditions carefully. Sign and date at the bottom of the form to acknowledge your agreement before submitting it back to DMBA.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (142 Votes)
2016	4 Satisfied (29 Votes)

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Is there an age limit for senior LDS missionaries?

Are senior members prohibited from serving any kind of mission (including away from home) if they are over age 70? Senior members of any age can serve as missionaries or service missionaries.

What are healthcare providers that contract with your insurance company are considered to be?

Theyre known as network providers or in-network providers. A provider that isnt contracted with the plan is called an out-of-network provider.

What is the age limit for senior missionaries?

Yes. Senior couples or single seniors (age 40 and older) can serve as full-time missionaries (away from home). Additionally, any members age 26 or older with a current temple recommend may serve as senior service missionaries (living at home) regardless of whether they are married or if their spouse is able to serve.

Can men over 40 serve LDS mission?

Single senior missionaries can choose to serve for 6, 12, 18 or 23 months. Along with now allowing single men over 40 with no dependents at home to serve missions, the roles of single sisters have been expanded to include serving in visitors centers, historic sites and employment centers.