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	Anthem Blue Cross Medicare Part D Prescription Plan
Toll Free (877)566-5454

CALL FOR QUOTE

•  QUOTE & APPLY ONLINE
•  Medicare Part D Application
•  Standard Evidence of Coverage
•  Standard Brochure
•  Standard Summary of Benefits
•  Plus Evidence of Coverage
•  Plus Brochure
•  Plus Summary of Benefits
•  Gold Evidence of Coverage
•  Gold Brochure
•  Gold Summary of Benefits
•  MedicareRX Formulary Lookup

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Mail all applications to:

BARRICKS INSURANCE SERVICES
13900 NW PASSAGE #302
MARINA DEL REY, CA 90292

OR FAX TO 1-310-827-0256

Fill in this form to have your Anthem Blue Cross Medicare Part D Prescription Drug brochure with pricing & application mailed to you. Further information on our plans is shown below. Or just call us Toll-free at 1-877-566-5454.

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