Fill the form below to apply for quotes.
First Name
Last Name
Phone Number
Zip Code
By clicking "Submit," I provide my electronic signature to SeniorsQuotesHelp, expressly consenting via this chat/webform interaction for a licensed sales agent associated with up to 8 insurance companies or their agents or Partner Comapnies to contact me at the number and address provided with insurance quotes, products and services, including Medicare Supplement, Medicare Advantage, Prescription Drug insurance plans, and other health-related services, for marketing purposes or to obtain additional information for such purposes using live telephone calls, automated dialing systems, artificial calls, pre-recorded calls, text, or email. (Message and data rates may apply). I understand this request has been initiated by me and is an unscheduled contact request. I further understand that this request, initiated by me, is my affirmative consent to be contacted, which is in compliance with all federal and state telemarketing and Do-Not-Call laws. By providing this consent, I acknowledge and agree that any disputes arising out of or related to this consent shall be resolved through binding arbitration in accordance with the Terms and Conditions. I understand that this is a solicitation for insurance. Participating sales agencies represent Medicare Advantage [HMO, PPO, and PFFS] organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a Special Enrollment Period. My consent is not a condition of purchasing any property, goods, or services, and I may revoke my consent at any time. To revoke consent, you may contact us via email at info@seniorsquoteshelp.com. I understand that the insurance companies or their agents may confirm my information through the use of a consumer report. I agree to this website's Privacy Policy and acknowledge that as a member, I will receive insurance quote reminders and special promotions sent to me via email. I also acknowledge that seniorsquoteshelp.com will Not Sell My Information. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users: 1-877-486-2048), 24 hours a day, 7 days a week. If your complaint involves a broker or agent, be sure to include their name when filing your grievance. We do not offer every plan available in your area. Currently, we represent 6 organizations which offer 2 products in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local State Health Insurance Program to get information on all of your options..
