Applications

Start a Service Request

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Missing AARP Membership Number

Applicant Name: {{appServiceModel.appDetailsObject.lastName}}, {{appServiceModel.appDetailsObject.firstName}}

AARP Membership Number: {{appServiceModel.appDetailsObject.aarpmemberNumber.replace('-','')}}

Prior to continuing with this request, please ensure your request is being submitted for the correct individual. Please verify that your client's name and AARP Membership Number listed above is accurate.

If an AARP Membership Number is not displaying above, please provide the Application #

Application #

All fields marked with an * are required.

Enter the AARP Membership Number *

Please enter a valid number

Where can an applicant find this?

Applicants can find their AARP Membership Number on the front of their AARP card located to the right of the expiration date. See image below.

Select the Person to Whom the AARP Membership Number Applies *

Please Select One

If You Chose Other, How Are You Related to the AARP Membership Holder? *

Please enter required data

The information provided will be reviewed by the Enrollment Department related to the identified application. If the application is not pending, this request will not be considered.

By clicking the Submit button below, you the agent/agent's representative agree the information is accurate and was provided by the applicant, and you are submitting this change request on their behalf.

We apologize, but we are unable to process your request at this time. Please resubmit the required information at a later time. Thank you for your patience.

Thank you for submitting your request!

Your change request for the above Applicant has been submitted.

Upon clicking on the Close button or the "X" in the upper right corner, you will be returned to the Service Request screen. From there you can choose another request for the same client or continue with the other activities.

Change Requested Plan Effective Date

Applicant Name: {{appServiceModel.appDetailsObject.lastName}}, {{appServiceModel.appDetailsObject.firstName}}

AARP Membership Number: {{appServiceModel.appDetailsObject.aarpmemberNumber.replace('-','')}}

All fields marked with an * are required.

Enter the Requested Plan Effective Date*

Please enter a valid date

The Plan Effective date must be after the signature date on the application, must be after the application receipt date, and must be no more then 12 weeks from the signature date.

The information provided will be reviewed by the Enrollment Department related to the identified application. If the application is not pending, this request will not be considered.

By clicking the Submit button below, you the agent/agent's representative agree the information is accurate and was provided by the applicant, and you are submitting this change request on their behalf.

Thank you for submitting your request!

Your change request for the above Applicant has been submitted.

We apologize, but we are unable to process your request at this time. Please resubmit the required information at a later time. Thank you for your patience.

Plan Selection Change (Pending Application)

Applicant Name: {{ appServiceModel.appDetailsObject.lastName }}, {{ appServiceModel.appDetailsObject.firstName }}

AARP Membership Number: {{ appServiceModel.appDetailsObject.aarpmemberNumber.replace("-", "")}}

If an AARP Membership Number is not displaying above, please provide the Application #

Application #

A pending application plan selection change request cannot be submitted via this method for applicants leaving or enrolling in an AARP® Medicare Supplement Plan insured by UnitedHealthcare® Insurance Company of America, applicants under the age of 65 or applicants enrolling in an AARP® Medicare Select Plan.

All fields marked with an * are required.

Please enter required data

Enter the Desired New Plan from the Menu *

The information provided will be reviewed by the Enrollment Department related to the identified application. If the application is not pending, this request will not be considered.

Thank you for submitting your request!

Your change request for the above Applicant has been submitted.

We apologize, but we are unable to process your request at this time. Please resubmit the required information at a later time. Thank you for your patience.

Missing Part A or Part B Effective Date

Applicant Name: {{appServiceModel.appDetailsObject.lastName}}, {{appServiceModel.appDetailsObject.firstName}}

AARP Membership Number: {{appServiceModel.appDetailsObject.aarpmemberNumber.replace('-','')}}

Application #

Enter Medicare Part A Effective Date

Please enter a valid date

Enter Medicare Part B Effective Date

Please enter a valid date

The information provided will be reviewed by the Enrollment Department related to the identified application. If the application is not pending, this request will not be considered.

We apologize, but we are unable to process your request at this time. Please resubmit the required information at a later time. Thank you for your patience.

Thank you for submitting your request!

Your change request for the above Applicant has been submitted.

Withdraw Pending Application

Applicant Name: {{appServiceModel.appDetailsObject.lastName}}, {{appServiceModel.appDetailsObject.firstName}}

AARP Membership Number: {{appServiceModel.appDetailsObject.aarpmemberNumber.replace('-','')}}

Application #

All fields marked with an * are required.

The applicant wishes to withdraw their pending application *

Input is required

The information provided will be reviewed by the Enrollment Department related to the identified application. If the application is not pending, this request will not be considered.

By clicking the Submit button, you the agent/agent's representative confirm the applicant has requested that their pending application be withdrawn, and you are submitting this request on their behalf.

Thank you for submitting your request!

Your change request for the above Applicant has been submitted.

We apologize, but we are unable to process your request at this time. Please resubmit the required information at a later time. Thank you for your patience.

Missing Date of Birth

Applicant Name: {{appServiceModel.appDetailsObject.lastName}}, {{appServiceModel.appDetailsObject.firstName}}

AARP Membership Number: {{appServiceModel.appDetailsObject.aarpmemberNumber.replace('-','')}}

Application #

All fields marked with an * are required.

Please enter a valid date

Enter Date of Birth*

Please enter a valid date

The information provided will be reviewed by the Enrollment Department related to the identified application. If the application is not pending, this request will not be considered.

We apologize, but we are unable to process your request at this time. Please resubmit the required information at a later time. Thank you for your patience.

Thank you for submitting your request!

Your change request for the above Applicant has been submitted.

Missing Phone Number

Applicant Name: {{appServiceModel.appDetailsObject.lastName}}, {{appServiceModel.appDetailsObject.firstName}}

AARP Membership Number: {{appServiceModel.appDetailsObject.aarpmemberNumber.replace('-','')}}

Enter a Daytime Number

Please enter a valid phone number

Enter an Evening Number

Please enter a valid phone number

We apologize, but we are unable to process your request at this time. Please resubmit the required information at a later time. Thank you for your patience.

Thank you for submitting your request!

Your change request for the above Applicant has been submitted.

Important Documents

For more information on enrollment and election periods for MA/PDP plans, see the Enrollment Handbook located in Knowledge Center/Guides.

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Contact the Producer Help Desk (PHD)

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Monday - Friday 9am - 9pm CST

Monday – Friday 7am – 9pm CST

phd@uhc.com ACABrokerSupport@uhc.com 888-381-8581 866-235-4095

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Start a Service Request

Missing AARP Membership Number

Thank you for submitting your request!

Change Requested Plan Effective Date

Thank you for submitting your request!

Plan Selection Change (Pending Application)

Thank you for submitting your request!

Missing Part A or Part B Effective Date

Thank you for submitting your request!

Withdraw Pending Application

Thank you for submitting your request!

Missing Date of Birth

Thank you for submitting your request!

Missing Phone Number

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Important Documents

Applications

Commissions

Tools

Sales & Marketing

Knowledge Center