Request Printed Materials

Fill this form to request information on benefits, limitations, costs, exclusions and eligibility
for the AARP Medicare Supplement Insurance Plans. Printed materials will be mailed to you.

*Required field

AARP Membership ID:
*First name:
*Last name:
*Address line 1:
Address line 2:
*City:
*State:
*ZIP Code:
*Medicare (Part B) effective date:
*Date of birth:
Phone number:
Email address:
	By providing your email address, you are agreeing to receive product information via email.

The AARP Medicare Supplement Insurance Plans carry the AARP name and UnitedHealthcare^® pays a royalty fee to AARP for use of the AARP intellectual property. Amounts paid are used for the general purposes of AARP and its members. Neither AARP nor its affiliate is the insurer.

AARP Medicare Supplement Insurance Plans are insured by UnitedHealthcare^® Insurance Company, Horsham, PA (UnitedHealthcare Insurance Company of New York, Islandia, NY for New York Residents). Policy Form Number GRP 79171 GPS-1 (G-36000-4). In some states, plans may be available to persons eligible for Medicare by reason of disability. All plans may not be available in your state/area. Call for complete information including benefits, costs, eligibility requirements, exclusions and limitations.

AARP does not recommend health related products, services, insurance or programs. You are encouraged to evaluate your needs.

This is a solicitation of insurance. An agent/producer may contact you.

AARP and its affiliate are not insurance agencies or carriers and do not employ or endorse insurance agents, brokers, producers, representatives or advisors.

Not connected with or endorsed by the United States government or the federal Medicare program.

WB25104 (03/10)WB25105 (03/10)

Questions? Call toll free

1-866-408-5545

(TTY: 711)

7 a.m.–11 p.m. ET, Mon–Fri
9 a.m.–5 p.m. ET, Sat

Where to find your AARP Membership ID

Your member ID is a 10-digit number located at the bottom of your AARP membership card.

If you’re not yet an AARP member, you can still receive printed materials, however you must be a member in order to enroll in a plan.

Where to find your Medicare (Part B)
effective date
Your Medicare (Part B) effective date is located on the front of your Medicare card.

How to get more information
If you still have questions about this form or the printed materials you are requesting, please call toll-free

1-866-408-5545

(TTY 711), 7 a.m.–11 p.m. ET, Monday–Friday, 9 a.m.–5 p.m. ET, Saturday.

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