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* Age: under 64 1/2	64 1/2 or older and my birthday is:
I am currently on Medicare by reason of disability or End Stage Renal Disease. If you are eligible for Medicare by reason of disability or end stage renal disease, you must select and apply for a Medicare Eligible plan over the phone. Please call a representative at 1-800-239-4280 (TTY: 711) between 9:00 a.m. - 9:00 p.m., Monday through Saturday.

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The premium for Medicare Supplement products is based on Tobacco usage.

Non-Tobacco user Tobacco user

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FBM ZIP 001 072010

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	1-877-465-1125 TTY users dial 711 Mon-Sat, 9am-9pm ET Sun, 12pm-4pm ET