Medicare Check-up Form

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MM slash DD slash YYYY
Are you open to having your prescriptions mailed to you, if it saves you additional money?
Medication List (Click "+" to Add More)
Drug Name
Dosage (MG Amount)
Times Per Day
 
Provider (Click "+" to Add More)
First Name
Last Name
Speciality
City
Zipcode
 

Inbisat S.
Inbisat S.
Robin puts in 100% into everything she does. What a great resource!!!
Kathleen Z.
Kathleen Z.
Laurie E.
Laurie E.
Robin Tefft (FJDTech T.
Robin Tefft (FJDTech T.
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“We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. This is a proprietary website and is not associated, endorsed or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program please visit the Official U.S. Government Site for People with Medicare located at http://www.medicare.gov