help you learn the basics of Medicare or explore the plans
available to you. We’ll get you all the information you need to
make confident decisions about your coverage.
Medicare regulations require that we obtain your consent
before we contact you to discuss Medicare Advantage plan(s).
PLEASE NOTE: This Consent to Contact Form is optional.
Submitting this optional form does NOT obligate you to enroll in
a plan, affect your current or future Medicare enrollment, or
automatically enroll you in a plan.
By completing this form, your information will be provided to a
licensed insurance agent. You may be contacted by a licensed
insurance agent. To contact an Independent Agent Call
(207) 706-6477
Not affiliated with or endorsed by
Medicare or any government agency.