Welcome to our Medicare Rx Coverage Screening Form!

We're excited you are looking to take control over your Medicare Coverage Strategy for 2018!

As Retirement Health Insurance Advisors, Medicare Mentors is a licensed, private fee-for-service firm to guide you through your individual Medicare coverage options to meet your needs. Medicare is far from one size fits all. Medicare Mentors will work with you to complete the Individualized Medicare Coverage Screening of your choice (Complete, Traditional, and Medicare Advantage) and provide the foundation of your 2017 Medicare Coverage Strategy. 

The following survey has been created to collect the key pieces of information needed to initiate the Medicare Coverage Screening process. Please review each question and answer to the fullest extent possible. The more accurate the information, the more accurate your screen results. 

Any questions, please contact us at info@MyMedicareMentors.com or visit Medicare Mentors' website for more information on our Medicare Coverage Screenings or Medicare Case Management Service!

This form is only intended to collect information and is not an agreement to service or commitment to complete a Medicare Coverage Screen.
Once this survey is received and reviewed, you will be contacted to discuss how Medicare Mentors can best facilitate your needs and complete required Service Agreement contract(s). 

Empowering Individuals to be Informed Consumers of Retirement Healthcare Options Through Education & Guidance