Would you like to learn more about Blue MedicareRx?
review the options below and let us know how we can help you

	I would like to receive a Blue MedicareRx information kit through the mail (or would like one sent to a friend or family member at the address provided below).
	I would like an authorized Blue Cross and Blue Shield of Illinois contracted agent to call me about Blue MedicareRx.
Please provide the following information (» required fields)
» First Name:
» Last Name:
» Permanent Address:
» City:
» State:
» Zip Code:
»  Home Phone Number:	( ) -
Your Birthdate:	/ / (mm/dd/yyyy)
Email:	I understand that by providing my e-mail address, I may receive future messages about Blue Cross and Blue Shield products and services.

---

More Information

---

• Request a free kit
• Have an agent contact you

---

Enroll Now

---

Fill out our safe, secure online form.

Enroll Now!

---

Additional Resources

---

• Summary of Benefits (PDF) 
• Evidence of Coverage
• Terms & Conditions
  • Fraud, Waste & Abuse
  • Low Income Subsidy
  • Contract Termination
  • Plan Transition Process
  • Grievances & Appeals
• Privacy Notice (PDF)
• About Medicare Part D
• News
• FAQs
• Contact Us
• CMS.gov*
• Medicare.gov*
• Socialsecurity.gov*