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Medicare Information  >>  Agent Resources  >> 

Short & Individual Enrollment Forms

Long Enrollment Form 2013

Short Enrollment Form 2013 MyPlan C Plan to Plan

Short Enrollment form 2013 MyPlan A,R,E Plan to Plan

Please fax completed forms to (503) 345-5751

 

Medicare Information:
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(503)-345-5702
1-800-458-9518
1-800-735-2900 TTY
Hours: Monday – Friday, 8 am – 5 pm


Medicare Sales:
1-866-225-2273 or 503-345-5701
Fax: (503) 345-5720
Email:
medicaresales@
familycareinc.org
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FamilyCare is a Medicare Advantage organization with a Medicare contract and a contract with the Oregon Medicaid program.
FamilyCare Health Plans
825 NE Multnomah, Suite 300
Portland, Oregon 97232 - 1.800.458.9518

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10/03/2012
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