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Scope of appointment

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. 

    Scope of Appointment Form -  Agent Jessica Cody

    The Centers for Medicare and Medicaid Services requires agents to document the scope of a marketing appointment prior to any face-to-face sales meeting to ensure understanding of what will be discussed between the agent and the Medicare beneficiary (or their authorized representative). All information provided on this form is confidential and should be completed by each person with Medicare or his/her authorized representative. Fields marked with an asterisk (*) are required.​
    By signing this form, you agree to a meeting with a sales agent to discuss the types of products you indicated above. Please note, the person who will discuss the products is either employed or contracted by a Medicare plan. They do not work directly for the Federal government. This individual may also be paid based on your enrollment in a plan.

    ​Agent Name: Jessica Cody
    ​Agent Phone Number: 828.484.7900


    Plans Represented During the Meeting: MAPD, PDP, Dental/Vision/Hearing Products
Submit
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.
Trout Insurance Services
Visit: 29 N Main St
Weaverville, NC 28787
     
Mail: PO Box 1414     
Weaverville, NC 28787
     
Ph: 828.279.4681
Fax: 1-888-221-4842
[email protected]
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Not affiliated with the U.S. Government or Federal Medicare Program.
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Trout Insurance is a full line insurance agency based in WNC. We serve clients in North and South Carolina as well as national companies. Trout Insurance offers life, health, disability, Medicare supplement, Medicare Health Plans, Medicare Prescription Plans, Long term care insurance, Home and Auto insurance for individuals. For businesses we offer group health & benefits, commercial liability, property & worker's compensation as well as plans for business owners. 

Dave Trout, David Hanson and Idelle Davids are independent insurance agents with Trout Insurance. 

​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.
  • Home
  • Enroll
  • Resources
    • Prescription Drug Payment Plan
    • Medicare Supplement Rate Increases >
      • Medicare Supplement: Plan "N"
    • Blue Cross Customer Service Information
    • Aetna Customer Service Information
    • United Healthcare Customer Service Information
    • Humana Customer Service Information
    • Alignment Platinum (HMO-POS)
    • December 8th and Beyond
    • ANOC "Annual Notice of Change" Statement
    • Hopscotch Health
    • Medicare - What Is Most Important To You
    • New To Medicare
    • Medicare Supplement Premium Increase?
    • Medicare FAQ's
    • Fitness
    • BLOG
  • Alignment
    • Alignment C-SNP
  • Benefits
  • Our Agents
  • Contact
  • Dave - Scope of Appointment
  • Permission To Contact