Forms · Current clients
Your forms for this year.
Open enrollment runs October 15th to December 7th. Getting these back early gives us more time to look at your options.
Got your forms in the post, but would rather do them online?
That’s no trouble at all. Your online forms come as a personal link that already has your details filled in, so we need to send it to you rather than put it on this page. Call or email Barb and she’ll send yours straight over.
Already had the email from us?
Open it and tap “Open my forms”— that link is yours and picks up wherever you left off. If you can’t find the email, check your junk folder, then give Barb a ring.
Or print a copy at home
Pick the one that matches your plan. Not sure which you have? Call Barb — it takes a moment to check, and filling in the wrong one is a wasted afternoon.
- Print this
Medicare Advantage
If your plan is a Medicare Advantage plan (Part C) — the one that usually covers your doctor visits, hospital and prescriptions together.
- Print this
Medicare Supplement and/or drug plan
If you have a Supplement (Medigap) plan, a stand-alone drug plan (Part D), or both.
- Send this one too
Scope of Appointment
Medicare requires this before we can talk about any Medicare plan. It only records which topics you’re happy to discuss — it doesn’t sign you up for anything. Goes with either form above.
When you’ve filled them in
Post them back to us, drop them at the office, or bring them to your next appointment — whichever is easiest. Any questions at all, call Barb on (216) 287-8832.
On a health plan rather than Medicare?
If Barb looks after an ACA or marketplace health plan for you, your forms are different — give her a ring on (216) 287-8832 and she’ll get the right ones to you.