United Insurance Services, LTD.
Products and Services - Medicare Supplement: Application
Thank you for your interest in Blue Cross Blue Shield of Illinois Medicare Supplements. In order to download your application, please follow the instructions below.
Step 1
Download and Print the Application**Note Adobe Acrobat Reader Is required
Step 2
The application you have downloaded has 4 pages in which 2 are duplicated for your convenience. Please fill out the 2 page application completely and remember to sign and date it.
Step 3
Place the application in an envelope and mail to:United Insurance Services c/o Direct Markets
6500 West College Drive
Palos Heights, IL 60463
