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Are you a Current Client of ours?
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What can we Help you with?
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Review My Plan
Medicare Advantage or Part D Prescription Questions
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3
Which of following applies to your Medicare situation?
I am turning 65 within the next 6 months OR I have turned 65 within the last 6 months
I am under 65 and eligible for Medicare
I am considering leaving/losing employer (group) coverage and DO NOT already have Medicare Part B
I am considering leaving/losing employer (group) coverage and have had Medicare Part B in effect for more than 6 months
I am already on Medicare and want to shop my plan
Something Else
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4
When did your Medicare Part B begin?
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Is your current plan a Medicare Advantage (HMO, PPO, $0/mo) plan OR a Medicare Supplement (Plan F, Plan G, Plan N) plan?
Medicare Advantage
Medicare Supplement
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6
Describe What We Can Help You With Below
Please also include your name and contact information where we may reach you. (Email Address or Phone Number)
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Name
First Name
Last Name
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8
Phone Number
Area Code
Phone Number
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9
Email
example@example.com
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