A Scope of Appointment form is required in all personal or individual face-to-face appointments where MA, MA-PD, PDP, and Cost Plan products are to be discussed with Medicare beneficiaries.
Please complete the form below.
We do not offer every plan available in your area. Currently we represent at least 8 organizations which offer at least 57 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.