OMB
.report
Search
Election Process (MA organization)
Model Medicare Advantage and Medicare Prescription Drug Plan Individual Enrollment Request Form (CMS-10718)
OMB: 0938-1378
IC ID: 240722
OMB.report
HHS/CMS
OMB 0938-1378
ICR 202401-0938-002
IC 240722
( )
Documents and Forms
Document Name
Document Type
Form CMS-10718
Election Process (MA organization)
Form and Instruction
CMS-10718 Enrollment Form
CY 2025- Model MA PDP Indiv Enrollment Request Form.pdf
Form and Instruction
CMS-10718 Enrollment Form (Spanish)
CY 2025- Model MA PDP Indiv Enrollment Request Form_Spanish.pdf
Form and Instruction
Information Collection (IC) Details
© 2024 OMB.report |
Privacy Policy