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Please complete the online application for Blue Shield of California Medicare Supplement plans, return it by email, or fax to (844) 266-1850.

For applicants from another carrier: 

A copy of the client's current Medicare Supplement plan ID card and a completed replacement form is required.

For existing Blue Shield Medicare Supplement members:

No ID card or replacement form required.

Please note, Plan F Extra, Plan G Extra, and Plan G Inspire do not have a high-deductible option. 

Your clients will have to purchase a separate Medicare prescription drug plan for Part D coverage.

Current Blue Shield Medicare Supplement plan members interested in applying for a richer benefit plan, or to an equal or lesser plan outside of the member’s Open Enrollment Period, must fill out the Medicare Supplement Plan Enrollment Form (English) (PDF, 504KB) or the Medicare Supplement Plan Enrollment Form (Spanish) (PDF, 238KB). 

Current Blue Shield Medicare Supplement plan members interested in transferring to a plan with equal or lesser benefits during the member’s Open Enrollment Period, please have them complete the transfer application (English) (PDF, 380KB) or the transfer application (Spanish) (PDF, 380KB) . The Open Enrollment Period starts on the first day of the member's birthday month and ends 60 days after their birthday.

Please note for enrollees in the Household Savings Program*: If you change plans, remember that the other household member must transfer to the same plan for your monthly savings to continue.

*Savings due to increased efficiencies from administering Medicare Supplement plans under this program/service and are passed along to the subscriber.



Page last updated: 1/11/2021