Thank you for choosing to use our expedited review process so we can help you navigate your medicare choices this year. Please take a few minutes to provide us your updated information. Please complete one separate form for each individual.
Disclaimer: Under Medicare laws, you are not required to provide any personal health care information. As a current customer, the information you are voluntarily providing cannot be used to determine eligibility. This information will solely be used to verify that your medications are covered on your plan’s drug formulary list. For more information regarding your Medicare rights, please click here.