top of page

myNeeds Analysis Form

Please fill out the following form
in order for us to better serve you.

Are you a current Medicare beneficiary or new to Medicare?
Why are you looking to change coverage?
Do you have a Healthcare POA or someone who helps with medical decisions?
Current Coverage
Do you feel that your isurance is costing you too much?
Do you currently have a Primary Care Physician (PCP)?
What do you consider to be the most important aspects of medical coverage? (Select any that apply)
Would you like information about plans in the area that may offer special coverage for beneficiaries with certain medical conditions, including diabetes, heart conditions, or Chronic Obstructive Pulmonary Disease (COPD) (Subject To Availability)

Thanks for submitting!

We're here to help you understand your options, enroll, & managing your plan options.

MEDICARE

 

Medicare Supplement

Medicare Health Plan (HMO,PPO,POS)

Medicare Part D (Prescription Drug)

Medicare Supplement

Special Needs Plan (Diabetes, Cardiovascular)

Special Needs Plan (Medicare-Medicaid)

​

HEALTH INSURANCE

 

Healthcare (ACA)

Short Term Medical

Limited Medical

Deductible Insurance

Cancer Insurance

Dental Insurance

bottom of page