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Form OHP7209 Request to End Medicare Advantage and Medicare Special Needs Plan Enrollment - Oregon
What Is Form OHP7209?
This is a legal form that was released by the Oregon Health Authority - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form OHP7209?A: Form OHP7209 is a request to end Medicare Advantage and Medicare Special Needs Plan enrollment in Oregon.
Q: Who can use Form OHP7209?A: Anyone enrolled in a Medicare Advantage or Medicare Special Needs Plan in Oregon can use Form OHP7209 to request to end their enrollment.
Q: How do I fill out Form OHP7209?A: You need to provide your personal information, the plan you want to discontinue, the effective date for discontinuation, and your signature to fill out Form OHP7209.
Q: Do I need to submit any supporting documents with Form OHP7209?A: No, you do not need to submit any supporting documents with Form OHP7209.
Q: How can I submit Form OHP7209?A: You can submit Form OHP7209 by mailing it to the address provided on the form or by contacting your plan provider for alternative submission methods.
Form Details:
- Released on October 1, 2016;
- The latest edition provided by the Oregon Health Authority;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form OHP7209 by clicking the link below or browse more documents and templates provided by the Oregon Health Authority.
