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Important Links & Forms
Medicare Part B Enrollment Form to Fax (CMS 40 B)
Request for Employment Information Form (CMS L564) ** provides proof of “creditable coverage" past 65
Medicare Costs - Including IRMAA tables
IRMAA Income Appeal instructions & form - (SSA 44) online application
Medicare payment methods (includes option to change to monthly EFT)
My Medicare.gov (website to manage your medicare plan - enter your prescriptions - etc)
Social Security Office online lookup (phone, fax, hours, etc)
SecureVistas Insurance Group represents Medicare Advantage HMO, PPO, PFFS, and Prescription Drug Plan organizations that have a Medicare contract. Enrollment depends on the plan’s contract renewal. Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. Every year, Medicare evaluates plans based on a 5-star rating system. Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply. SecureVistas Insurance Group is a non-government website and is not endorsed by the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services (DHHS) or any other government agency.
We do not offer every plan available in your area. Currently we represent 6 organizations which offer 41 products in our area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options
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 (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.
To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.