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1. I acknowledge and understand that neither Evans Financial Group nor Advisors Excel, LLC or any of their respective representatives are affiliated with Medicare, CMS or any government agencies.
2. I give my written consent for representatives of Evans Financial Group, 7600 Fern Ave., Building 1200, Shreveport LA 71105 to contact me about Medicare via any of the contact information I have provided in this form.
3. I hereby request a Medicare quote. I acknowledge and understand that I will be contacted by a licensed insurance sales agent regarding the purchase of a Medicare Supplement policy and/or a Medicare Advantage plan.
4. Coverage purchased after initial enrollment period are subject to eligibility requirements. Guarantees are backed by the financial strength and claims-paying ability of the issuing insurer.
5. 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.
6. By providing the information above, I grant permission for licensed insurance agent, Evans Financial Group, to call or email me regarding my Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.