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Keep Your Family Together And Protect Your Rights

The Centers for Medicare and Medicaid Services (CMS) requires agents to document the scope of a marketing appointment prior to any face-to-face sales meeting to ensure understanding of what will be discussed between the agent and the Medicare beneficiary (or their authorized representative). All information provided on this form is confidential and should be completed by each person requesting contact. By signing this form, you agree to a call with a sales agent in 48-hours or when an agent is next available, whichever comes later, to discuss Medicare Advantage, Prescription Drug, Medigap, and supplemental health insurance benefits. Please note, the person who will discuss the products is employed by Family First Insurance Advisors and contracted by a Medicare plan. They do not work directly for the Federal government. This individual may also be paid based on your enrollment in a plan.

By providing your contact information you are agreeing to be contacted by a licensed agent or sales representative by mail, phone, text or email to discuss Health Insurance Plans, Dental Insurance Plans, Medicare Advantage, Prescription drug Plans, Medicare Supplement Insurance Plans and any other products or services we may offer even if you are on the National Do Not Call Registry. You also agree that we may contact you via a pre-recorded message to verify your interest. Neither Family First Insurance Advisors LLC nor its agents are connected with either the Federal Medicare Program or Healthcare.gov. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-Medicare to get information on all of your options.

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