Medicare Supplements for Seniors
To apply for a Medicare supplement plan you must be age 65 or older and have Part “A” and Part “B” from social security and provide the following

Information for us to provide you with a proper quote for your Medicare supplement….

Name:
Address:
City:
State:
Zip Code:
Phone:
E-Mail:
Birth Date:
Effective Date of Medicare Part A:
Part B:
Send Long Term/Home Care Information:
 

 

Please Note: We will mail you the current year Federal guide for Medicare supplements, Long Term Care and call or email you to discuss these plans with

You to determine which is best for your medical needs and budget……..

---Medicare Part “D” for prescription drugs

--- We recommend that you go to the www.medicare.gov website and go to the prescription drug part D section and put in your prescription drugs that you

You are currently taking and the program will find the best Part “D” plan for your prescription drug usage….

---- Long Term Care-LTC & Home Care

--- Please fill in the information above and will send you the Federal guide for Long Term Care and contact you to discuss and answer any questions you have regarding this coverage.