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Please provide your client
with all materials in each product
section for a complete packet.
Individual Plans
Medicare Advantage (PPO) and Part D Prescription Plans
Regence MedAdvantage + Rx Enhanced (PPO), Regence MedAdvantage + Rx
Classic (PPO) and Regence MedAdvantage (PPO)
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Enrollment Form
- Short Enrollment Form (for existing members to upgrade their plan)
All pages of this form must be given to inquiring or applying individuals.
Medicare Script Enhanced (PDP) and Medicare Script (PDP)
Medicare Companion (Medigap) Plans
View and print information for Oregon residents
View and print information for Clark County,
Washington residents.
Claim Forms
Miscellaneous Forms
Note: To print a PDF document, you need Adobe® Reader®. Download it now for free.
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