Medicare Supplement Plans

Use these customer-friendly resources when talking with your clients about Premera Medicare Supplement.

2024

• 2024 Substitute outline of coverage – Includes rates and cost shares.
  2024 Resumen de Cobertura complementaria de Medicare


• 2024 Medicare Supplement enrollment application
  2024 Solicitud de inscripción complementaria de Medicare de Washington


• Replacement notice


• 2024 Digital enrollment kit


• Spousal discount form - Send completed forms to the address listed on the form or email to spousaldiscountforms@premera.com. This mailbox is not monitored, it's for receiving forms only.
  Acuerdo con el cliente Autorización de cambio - Descuento en la prima para cónyuges


• Spousal discount FAQ

Medicare Supplement producer supply order form

Medicare Supplement guaranteed issue requirements

Medicare Supplement automatic funds transfer authorization form

Producer of record change form

Deniable conditions form

Medicare agent transfer policy

A trusted name in healthcare, Premera provides more than just benefits. Here are a few features that provide extra value to your clients.

• Automatic fund transfers(AFT) and credit card payments save your clients money each month.
• 24-Hour NurseLine offers free and confidential advice from nurses. Members should call the phone number on the back of their ID card.
• Fitness program from FitOn Health is included for members enrolled in 2010 standard Plan A, Plan C, Plan F, Plan F High Deductible, Plan G, Plan G High Deductible, and Plan N. FitOn Health has a national network of over 13,000 fitness facilities and at-home streaming options. For more information, view FitOn Health FAQ
• Senior discounts program features exclusive discounts for our Medicare Supplement members, including hearing aids and screenings, eye care services, and medical alert systems.

The following are sample letters that were mailed to Premera Medicare Supplement customers.

• Sample annual notice letters: Mailed in November and show 2024 cost shares.
• Sample rate letters: Will mail in March and show 2024 rates. 

*Letter numbers are found in the lower right-hand corner of the first page

Older plan designs

*Letter numbers are found in the lower right-hand corner of the first page

Medicare & You - government handbook from the Centers for Medicare and Medicaid Services

Other Medicare Publications