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Medicare Advantage Individual Enrollment

CBC Medicare PPO Redirect

Have this information on hand to complete your enrollment application

  • Your red, white, and blue Medicare card.
  • If you need any assistance completing this application, please call us at 800.990.4201 (TTY: 711).

Required fields are noted with an asterisk *.

Medicare beneficiaries may also enroll in Capital Blue Cross PPO/HMO through the CMS Online Enrollment Center located at http://www.medicare.gov.

Updated October 1, 2022

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