FirstMedicare Direct  
 

 

Annual Compliance Attestation

Annual Compliance Attestation Form PDF

FDR Medicare Compliance Program Guide PDF

FCC Offshore Services Attestation Form PDF

Please complete the form in its entirety, and print, sign, and date the attestation. 

Mail the completed form to :

FirstCarolinaCare Insurance Company
ATTN: Compliance
42 Memorial Drive
Pinehurst, NC 28374

If you have any questions, please call FirstCarolinaCare Insurance Company at (910) 715-8152.

Thank you for your continued cooperation.

FirstCarolinaCare Insurance Company’s FirstMedicare Direct plans are HMO and PPO plans with a Medicare contract. Enrollment in a FirstMedicare Direct plan depends on contract renewal.This is a required statement by CMS. FirstCarolinaCare has filed and been approved to offer an HMO and a PPO Medicare Advantage Prescription Drug plan for 2020.

 
Y0094_20042M_Accepted_10/01/2019

Page Last Updated:
Friday, October 2, 2020 11:15:18 AM