Supplemental Medicare Subsidy Application

"All About" the Supplemental Medicare Subsidy Application

This form is for use by retirees or beneficiaries who are enrolled in a Medicare Supplemental Insurance program who wish to apply for the subsidy of $31 provided by the National Pension Fund. The $31 subsidy is paid to qualifying Medicare Supplemental insurance companies.

Procedures

Provide the complete name and address of your supplemental insurance provider. The Administrator should be a contact person at the insurance company.

Complete all of the general information, making sure to print clearly. If your spouse is not covered or to be considered for this subsidy payment, DO NOT complete that portion of the form.

You must enclose a copy of a Medicare card showing enrollment in both Parts A & B for each enrollee, you must also provide proof of your Local Union membership, and you must provide a copy of your pension check stub or voucher.

Make sure to sign the form on the appropriate line, print it, and mail it to:

Sheet Metal Workers' National Pension Fund
601 N. Fairfax Street, Suite 500
Alexandria, VA 22314

The Fund office will not accept this information via e-mail, as we require a signature. You should click on Subsidy INFOPACK for more complete information on this program.

Who to Contact

Pension Benefits Department by e-mail
Or contact the Pension Benefits Department
Phone (800) 231-4622, (703) 739-7000, Fax (703) 683-0932