Changes for Medicare Supplement Plans C and F - Blue 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Applicant Information' section. Ensure you provide your first name, last name, Social Security number, and address. All fields marked must be completed.
3. In the 'Plan Selection' section, check the box next to the plan you wish to enroll in (C or F). Review eligibility criteria carefully before making your selection.
4. Complete the 'Medicaid Information' section if applicable. Indicate whether you are covered under Medicaid and if it pays for your premiums.
5. Fill out the 'Health Information for Non-guaranteed Issue' section if you're not applying during an open enrollment period. Answer all health-related questions honestly.
6. Review all information entered for accuracy. Once satisfied, proceed to sign and date the application at the end of the form.

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