Special Agent
Guru
- 622
[h3][/h3]this is what the statement of understanding says .....Source? So we can't help people enroll?
[h3][/h3]
I understand and agree to the following:
- I must keep Hospital (Part A) or Medical (Part B) to keep Wellcare Classic (PDP).
- By joining Wellcare Classic (PDP), I acknowledge that this plan will share my information with Medicare, who may use it to track my enrollment, to make payments, and for other purposes allowed by Federal law that authorize collection of this information.
- The information I entered is correct to the best of my knowledge. I understand that if I intentionally provide false information on this form, I will be disenrolled from the plan.
- I understand that people with Medicare are generally not covered under Medicare while out of the country, except for limited coverage near the U.S. border.
If a person legally authorized to act on my behalf checks the box below, it certifies that:
- This person is authorized under state law to complete this application, and
- Documentation of this person's legal authority is available upon request by Medicare.
Who is the person completing this application?
I am the person joining the plan (or I am helping the person join the plan)
I am the person legally authorized under state law to act on the behalf of the person