I have a Medicare Advantage plan and shopping during Med Adv OEP
Jan 1st – March 31st
First Name
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Last Name
*
Email
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Date of birth
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Phone
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Is the phone number you provided any of the following?
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Business
Cellular
Home
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List is empty.
Which Medicare Advantage plan do you have now?
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Aetna
BlueCross BlueShield of IL
Humana
United Health Care
Other
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List is empty.
If Other, what is the name of the plan?
Reason for shopping:
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My doctor's not in the network
I want better benefits / different plan
I want to return to Original Medicare
Other
If Other, please tell us the reason you are shopping:
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