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! am not eligible to enrol before October 15.
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According to Medicare Rules, we need your permission to contact you to discuss Medicare Plan Options. By signing this form, you agree to a sales telephone call or an email from a licensed sales agent to discuss the specific product types above. The person who will be discussing plan options with you is with or contracted by a Medical Health Care Plan or Prescription Drug Plan that is not the Federal Government, and they may be compensated based on your enrollment in a plan. Signing this does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage Plan, Prescription Drug Plan, or other Medicare plans