Medicare Forms & Fliers

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Medicare Advantage Forms

Medicare Advantage Pre-Enrollment Forms

Permission to Contact Form (PDF) - English | Spanish
Scope of Sales Appointment Confirmation Form (PDF)
Pre-Enrollment Checklist (PDF)
2023 Presales Book Service Area 1 (PDF) - English | Spanish
2023 Presales Book Service Area 2 (PDF) - English | Spanish
2023 Enrollment Request Form (PDF) - English | Spanish
2023 Attestation of Eligibility Form (PDF) - English | Spanish
2023 Summary of Benefits Service Area 1 (PDF)
2023 Summary of Benefits Service Area 2 (PDF)

 

Medicare Advantage Post-Enrollment Forms

Bank Account Withdrawal Pre-Authorization Form (PDF)
Prescription Claim Form (PDF)
Appointment of Personal Representative (PDF)

MedPlus Forms

MedPlus Agent Contracting

Agent/Agency Update Form (PDF) General Agency Use
General Agency Contacts for New Agents (PDF)
Consumer Direct Products Independent Contractor Form (PDF) Agent Use

MedPlus Pre-Enrollment

Replacement of Coverage Form (PDF)
Broker Acknowledgement Form (PDF)
Pre-Sales books:

MedPlus Post-Enrollment

MedPlus Household Discount Request Form (PDF)
Membership Change Form (PDF)
Reinstatement Request Form (PDF)

General Information Forms

Authorization for Access to Personal Information (PDF) HIPAA release

Medicare Sales Tools

General

CareFirst’s Medicare Made Simple Guide (PDF)
How to Apply to Medicare (PDF)
Medicare Enrollment Period Snapshot (PDF)
Tips for Relationship Building (PDF)
Which Plan is Right for Me? (PDF)
Your Medicare Costs At-A-Glance (PDF)
Who to Contact - FMO and GA (PDF)
Who to Contact - Writing Agents (PDF)
2022 MA Agent Manual (PDF)

 

Medicare Advantage

100-Day Prescription Fill Flier (PDF)
Medicare Advantage Open Enrollment Period (PDF)
Agent Do’s and Don’ts of Medicare Compliance (PDF)
2023 Medicare Advantage Sales Presentation (PPT)
2023 Top 100 Drugs Flier (PDF)
Appointment Checklist (PDF)
The Medicare Advantage Difference: Whole Health (PDF)
How Does Your Current Medicare Plan Measure Up Flier (PDF)
What to Expect After You Enroll (PDF)
Why CareFirst Brochure (PDF)

 

Medicare Advantage Supplemental Vendors

Video Visit
Nations Hearing
SilverSneakers Fitness
Blue365 Flier - Coming Soon

 

MedPlus

MedPlus Sales Brochure (PDF)
Medicare & MedPlus 2023 Updates (PDF)
CareFirst Dental - It's the Right Decision Flier (PDF)
SilverSneakers Fitness
Blue365 Flier - Coming Soon

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