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This short video explains how to submit the Medicare Advantage Plan Review form and why the information is needed to complete the Review.
Medicare Advantage Plan Review
Depending on where you live, there could be ten (10) to fifty (50) different Medicare Advantage Plan options available.
If you would like some assistance reviewing these options to find the most appropriate plan option(s), you can complete the form below.
If you would like some assistance reviewing these options to find the most appropriate plan option(s), you can complete the form below.
- FOR ANNUAL REVIEW FORMS SUBMITTED AFTER NOVEMBER 15, THERE IS NO GUARANTEE WE WILL HAVE A CHANCE TO REVIEW & RESPOND BY DECEMBER 7 DEADLINE. WE WILL GIVE BEST EFFORTS, BUT WE CANNOT GUARANTEE A RESPONSE BY DECEMBER 7 DUE TO THE VOLUME OF REQUESTS.
- Do NOT include Vitamins, Supplements, or OTC drugs since these are not covered by Part D. Please ONLY list Prescribed Medications in the form.
- If you are taking prescribed medications that are NOT pill form (e.g. Insulin, Eye Drops, Creams, Lotions, Inhalers), in the "times per day" field below please just enter the amount per month that you fill (e.g. 5 pens per month, 1 bottle per month, 1 inhaler per month, etc.)
- If your drug is "as needed" or "PRN" please put an estimate in the "times per day" fields below (e.g. refill inhaler twice per year).
The form below is for existing clients, or new clients that have already set an appointment or phone appointment.
If you have more than 10 drugs to enter, put the additional drugs (Drug 11, 12, etc.) in "Additional Drugs/Info" field.
If everything was entered correctly, after you click SUBMIT you should receive a Confirmation page and a Confirmation email.
Please do not click the SUBMIT button more than one time - since this will create duplicate submissions.
If everything was entered correctly, after you click SUBMIT you should receive a Confirmation page and a Confirmation email.
Please do not click the SUBMIT button more than one time - since this will create duplicate submissions.