By submitting this form you agree that a licensed insurance agent employed with e-TeleQuote Insurance, Inc., may contact you regarding Medicare Advantage Dual-Eligible Special Needs plans. You expressly consent to receive phone calls (including autodialed and/or pre-recorded calls) text messages and email using automated technology at the phone number and email address you provided, even if it is a wireless number, regardless of whether you are on any Federal or state DNC ("Do Not Call") and/or DNE ("Do Not Email") list or registry. In addition, you understand and acknowledge that data and message rates may apply. Furthermore, you acknowledge that you are over 18 years of age.
Online quotes may not be available for all Medicare Advantage Dual-Eligible Special Needs plans, but the agency that will be discussing these plan options with you is contracted with various Medicare health plans. The licensed agent may be compensated based on your enrollment in such a plan. Submitting this form does NOT affect your current Medicare Part A and Part B enrollment, nor will it enroll you in a Medicare Advantage Dual-Eligible Special Needs plan.
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