Plan Information and Forms
Find helpful prescription drug plan resources including forms, plan materials and more.
Note: PDF (Portable Document Format) files can be viewed with Adobe® Reader®. If you don't already have this viewer on your computer, download it free from the Adobe website.
Sign in to view details about your coverage. When you sign in, you can track and manage your spending to date, including your total drug costs and out-of-pocket costs. You can also print a temporary member ID card or order a replacement member ID card, among other tasks. If you don't have an account, please register.
To get an AARP MedicareRx Plans insured through UnitedHealthcare enrollment form (PDF), go to View plans and pricing and enter your ZIP code. Choose one of the available plans in your area and view the plan details. You'll find the form you need in the Helpful Resources section.
Payment and reimbursement forms
Other forms and plan materials
To request disenrollment from your Medicare prescription drug plan and switch to Original Medicare only, you have two options to choose from:
Last updated: 04.28.2016 at 12:01 AM CT | Y0066_160317_094047 Accepted