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Form CMS-10718 Enrollment Form
Model Medicare Advantage and Medicare Prescription Drug Plan Individual Enrollment Request Form (CMS-10718)
CY 2025 revised - Model MA PDP Indiv Enrollment Request Form (clean)
Election Process (Beneficiaries)
OMB: 0938-1378
OMB.report
HHS/CMS
OMB 0938-1378
ICR 202504-0938-004
IC 240302
Form CMS-10718 Enrollment Form
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