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Regence BlueShield has been providing health care coverage to Washington residents for more than 86 years. Serving more than 1.1 million members, they are one of the leading healthcare
service providers in the State of Washington. Of the 10 Medicare Supplement (Medigap) plan designs that are available on the market, Regence offers five of these (plans A, C, E, F and I) to
enrollees who are over age 65 and enrolled on Medicare Parts A and B. If you are under age 65 and eligible for Medicare due to a disability, Plan A is the only option available to you.
Enrollment Forms & Instructions
- Complete the Application for Supplement to Medicare. If you are replacing another Medicare
Supplement policy with this coverage you must also sign a Replacement Form. We also
recommend that you complete the Subscriber Agreement for Preauthorized Bill Pay so that
premium payments are deducted automatically from your checking account.
- Do not submit any money at this time. You will be billed once your application has been approved. Submit your enrollment forms to:
R. L. Evans Company, Inc. 600 Stewart St., Suite 1210 Seattle, WA 98101
Need Help? 206.448.7878 (or 1.800.987.8199)
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