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APPLY NOW*
If you are 65 or older and not already a Blue Cross and Blue Shield subscriber, you may apply for 65 EXTENDED now. Fill out the application form and mail today to Blue Cross and Blue Shield, 4010 West Broad Street, Richmond, Virginia. Send no money. Applications received by May 25 become effective with Medicare—July 1, 1966.
*TO ALL BLUE CROSS AND BLUE SHIELD SUBSCRIBERS: There is no need for you to complete this application for 65 EXTENDED. If you are 65 or over, you will receive full information regarding your VHSA and VMSA Blue Cross and Blue Shield coverage in the mail or where you work. If you do not receive such notification within 30 days, you should contact your local Blue Cross and Blue Shield office, or your group administrator.
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BLUE SHIELD
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