Request a Medicare plan information kit

Please complete the form below to request your free information kit.

I would like a UCare Medicare Advantage plan information kit. UCare offers a broad range of plans, including plans with flexible spending accounts and with or without built-in Medicare Part D coverage. Dental is always included. I would like a UCare Medicare Supplement plan information kit. Also called Medigap, these plans provide medical-only coverage with no network requirements and little-to-no copays. Plus, you can keep your same benefits if you move to another state.

First Name

Last Name

Address

City

State

Zip Code

County

Phone

Are you currently enrolled in Medicare? Yes No

When do you plan to enroll in Medicare?

Name of current health plan (if any):

A Medicare sales specialist may follow up with you.

Request a Medicare plan information kit

Questions?