Navigating your Medicare Coverage options does not need to be an intimidating experience.

Medicare

We use easy-to-understand language to help clients better comprehend their choices. Additionally, we will help guide you through an easy process of selecting a Medicare Plan that makes sense for you.

Affordable, competitive rates. No hype, no obligation.

You can enroll in a Medicare Supplement Plan without medical underwriting — IF you apply during your six-month open enrollment period that begins when your Medicare Part B becomes effective. Don’t miss it!

On a Medicare Advantage Plan? We can help you select a plan every year during Medicare’s Annual Election Period.

Request your Medicare insurance quote here! Whether you are a new Medicare beneficiary or purchased a Medicare Plan years ago, we are here to help you explore your plan options. We are pleased to offer you Medicare insurance quotes without any obligation to apply.

Boys and Collins Financial Group is an independent agency. Therefore, we work closely with several insurance carriers and plans so we can help customize a solution that fits your needs.

Note: The information gathered from the form below is for Medicare quotes only. This site is not designed to assist Medicare beneficiaries with enrollment in Supplement, Advantage or Prescription Drug Plans.

Securities offered only by duly registered individuals through Madison Avenue Securities, LLC (MAS), member of FINRA/SIPC. Insurance products are offered through the insurance business Boys and Collins Financial Group. Boys and Collins Financial Group is also an Investment Advisory practice that offers products and services through AE Wealth Management, LLC (AEWM), a Registered Investment Advisor. AEWM does not offer insurance products. The insurance products offered by Boys and Collins Financial Group are not subject to investment Advisor requirements.

Any and all other services referenced are an outside business activity not offered through or supervised by AE Wealth Management. Investment advisory services provided by AEWM. Boys and Collin Financial, AEWM are all separate and not affiliated entities.

Medicare Coverage

Medicare Coverage Form

Name*
First Last
Spouse's First and Last Name (if applicable)
First Last
Email*
Street Address
Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number*
(Indicate primary use, i.e., cell, home, work)
Current Age*
Spouse's Current Age
Medicare Part B Effective Date*
MM slash DD slash YYYY
Spouse's Part B Effective Date
MM slash DD slash YYYY
Medicare Plan?
- Click this box if you currently do NOT have a Medicare Plan
Medicare Plan insurance carrier (if applicable)
What type of Medicare Plan?
If Supplement, what plan letter? (For Example, Plan F, or Plan N)
Spouse's insurance carrier (if applicable)
What type of Medicare Plan?
If Supplement, what is your spouse's plan letter? (For Example, Plan F, or Plan N)
By clicking “SUBMIT” you are agreeing to the following three statements:

1. I acknowledge that Boys and Collins Financial Group Retirement & Income Strategies is not affiliated with Medicare, CMS or any government agencies.

2. I give my written consent for a Boys and Collins Financial Group Retirement & Income Strategies staff member or agent to contact me through the contact information I have provided in this form.

3. I hereby request a Medicare Supplement quote from Boys and Collins Financial Group Retirement & Income Strategies. I acknowledge and understand that I will be contacted by a licensed sales agent regarding the purchase of a Medicare plan.
• Lastly, are you aware that submitting this form does not enroll you into Medicare or a Medicare-related product?*
- Yes
- No

By submitting your personal information, you consent to be contacted by a financial professional regarding your financial strategy for retirement.

Plans purchased after initial enrollment period are subject to eligibility requirements.

Ready to Take The Next Step?

For more information about any of the products and services listed here, schedule a meeting today or register to attend a seminar.

Schedule a Meeting

Or give us a call at 765.342.8686

Navigating your Medicare Coverage options does not need to be an intimidating experience.

Medicare

Affordable, competitive rates. No hype, no obligation.

Medicare Coverage

Medicare Coverage Form

Ready to Take The Next Step?

Contact Us

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