Life Insurance Form

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shieldmylife.com is operated by Insurancease.com (INSURANCEASE LLC), which is an independent broker and is not a Federal or State-controlled Marketplace website, nor is it affiliated with any governmental entity. This website is owned and operated by INSURANCEASE LLC, a licensed insurance agency, NPN #19825096. Invitations to apply for health insurance on shieldmylife.com, are available only where properly licensed and appointed. License numbers are available upon request and are provided where required by law.

Federal Contracting Statement: Medicare Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

Third-Party Material (TPMO) (Medicare.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.

Submittal of forms or an Application for Insurance does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement Plan, or any other Medicare plan. shieldmylife.com is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency.

The plans represented on Yourinsurancease.com are Medicare Advantage HMO, PPO, and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all available benefits. Specific benefits may vary by carrier, play year, and location. Check your official benefits disclosure for a full list of applicable benefits. Limitations and exclusions may apply.

Medicare Part B Premium give-back is not available with all plans. Availability varies by carrier and location. The actual Part B premium reduction could be less. Deductibles, copays, and coinsurance may apply.

This information is not a complete description of the benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

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3750 Bogner Dr, Woodbridge, VA 22193
+1 (888)-431-1104
info@shieldmylife.com
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