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Need Assistance?

Call 1-866-303-BLUE (2583) to speak with one of our knowledgeable sales representatives(After dialing, select option 1 for an agent, then select option 2 for Plan65.)

Plan65 Information Request Form

Blue Cross and Blue Shield of Oklahoma will send you a packet of information about Plan65.

Look over the materials and decide which Medicare supplement plan best suits your needs.

What to do:

Simply complete the form below, and a Plan65 informational packet will be sent to you shortly.

Your information:                                    *Optional Information

Name:    

Address:

  

City:

 

State:

  Zip:

Phone number:

 

Age:

        

Date of Birth:
(mm/dd/yyyy)

*E-mail address:

Do you currently have another Medicare supplement plan? Yes No

*If yes, which company?

Are you currently a Blue Cross and Blue Shield of Oklahoma member? Yes No

You may apply for Plan65 coverage if:

  • You have Medicare Part A and B and;
  • You are an Oklahoma resident and;
  • You are age 65 or older.