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You can apply for our plans in one of the following ways:
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Option 1. Download & Print Application Now.
You can download the application, print it out, and mail or fax it to our office. Please be sure not to skip the last page of this application file. This page is your application for membership in the Ohio Farm Bureau, which is required to apply for SuperMed One - Ohio Farm Bureau.
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SuperMed One - Ohio Farm Bureau
P.O. Box 239
Litchfield, Ohio 44253
Toll free: 800/722-7331
Fax: 330/721-8815 |
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Option 2. Request An Application.
We can send you an application by mail, email, or by fax. Just fill out the form below. |
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Option 3. Would you rather talk to us?
Just call us at 800/722-7331 and we'll help you apply step-by-step. |
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Additional instructions: |
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Call 800/722-7331 if you need help or to learn more. |
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Once you have downloaded and printed out the form write clearly using a blue or black ballpoint pen. |
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After carefully reading each section and answering all questions, be sure to sign and date the application. All applications will be considered invalid 60 days after the signature date. |
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What happens next: |
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Once your application is received, it will be reviewed to ensure that all information is accurate and all questions completed. |
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Your application will be sent to Medical Mutual's Underwriting department for further review. |
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Within five to seven days, we will notify you of your acceptance (including your actual monthly premium) or inform you if you have been denied coverage. At that time, if you accept the approved premium rates, an invoice for the first month of premium will be mailed to you. |
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Do not cancel any current health insurance coverage until you receive an approval letter and insurance policy, also known as insurance contract or certificate, from Medical Mutual. Make sure you understand and agree with the term of the policy. Pay special attention to the effective date, premium amount, benefits, limitations, exclusions, and riders.
The rates quoted are estimates only, and are subject to change based on your medical history, the underwriting practices of Medical Mutual of Ohio, the optional benefits you selected, if any, and other relevant factors. Medical Mutual of Ohio reserves the right to change the terms of the policy under proper notification. |
