Call us at 1-800-247-4422 or fill out this form. (Depending on the time of year, response time will vary.)
Are you currently enrolled in Medicare?
What help do you need? (Check all that apply.)
I don't know.
Medicare Prescription Drug Plan
Medicare Advantage (Part C)
Medicare Supplement Insurance
Medicare and my employer-based health plans
Medicaid or Extra Assistance Program
Long-term care Coverage/insurance
Which of the following most closely describes your questions? (Check all that apply.)
I need help choosing a good Medicare plan for me.
I need help paying for my prescription medications.
I have a problem getting medical care.
I have a question about my bills from my insurance company, the hospital, or my doctors.
I need help with my Low Income Subsidy (LIS) and/or Medicare Savings Program (QMB, SLMB, or QI-1) application.
We can help you find the Drug Plan that is most cost effective for you. Do you want to learn more about
a cost-comparison of your Prescription Drug Plan options? /
Not sure at this time.
(Open Enrollment for your Prescription Drug Plan is October 15 - December 7 of each year OR you may be eligible for a Special Enrollment Period.)
Do you qualify for "Extra Help" with Medicare costs?
This may be the case if your income is below $1,528/month for a single individual or $2,050/month
for a married couple and you meet asset limit tests.
Best way to contact you? Email or
County of residence
Knowing your zip code will help us send your question to the person who can best help you. What is your zip code?
What is your age?
65 or older
Tell us more about why you are contacting us today: