How to Enroll

• Print off the required application forms:
  • BlueCross65 Application (PDF)
  • Medicare Supplement Replacement Form (PDF)- Please include this form if you are switching from another Medicare Supplement plan. 
• Select the BlueCross65 plan that best fits your needs and budget.
• Complete and sign your application. (If you are currently a BlueCross BlueShield of Tennessee customer – or you are enrolling in BlueCross65 within the first six months after you enroll in Medicare Part B, you may SKIP the section that asks health questions).
• Please attach proof of current health insurance if you have any.
• Mail your application to:
  • BlueCross BlueShield of Tennessee
    Attn: BlueCross65 – MA-EG
    801 Pine Street
    Chattanooga, TN  37402
  • or FAX (423) 296-4582

Send no money now!

You'll be billed later, based on the payment preference you select on your application form. 

Apply today with NO RISK!  Your satisfaction is GUARANTEED or your money back!

Your satisfaction is important to us! Once you receive your BlueCross65 contract, take some time to look it over carefully. If you're not 100% satisfied, return your contract and ID card within 30 days of the effective date. We'll gladly refund any payments you have made (less any benefits provided) with no questions asked.

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