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Welcome to NYC.gov | City of New YorkPlease note: If enrolling in a Medicare HMO, you must complete and submit the attached form as well as contact the Medicare HMO directly to request

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Page 1: Welcome to NYC.gov | City of New YorkPlease note: If enrolling in a Medicare HMO, you must complete and submit the attached form as well as contact the Medicare HMO directly to request
Page 2: Welcome to NYC.gov | City of New YorkPlease note: If enrolling in a Medicare HMO, you must complete and submit the attached form as well as contact the Medicare HMO directly to request
Page 3: Welcome to NYC.gov | City of New YorkPlease note: If enrolling in a Medicare HMO, you must complete and submit the attached form as well as contact the Medicare HMO directly to request
Page 4: Welcome to NYC.gov | City of New YorkPlease note: If enrolling in a Medicare HMO, you must complete and submit the attached form as well as contact the Medicare HMO directly to request

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