Eligibility - InsBenefitsPlaza

Skip to content

Medicare Advantage
Medicare Supplement
Schedule Appointment

Medicare Advantage
Medicare Supplement
Schedule Appointment

Login

Medicare Advantage
Medicare Supplement
Schedule Appointment
Log In

Medicare Advantage
Medicare Supplement
Schedule Appointment
Log In

✔ Applicant Info

2. Eligibility

3. Review & Submit

Eligibility Form

Medicare Information

Medicare Number

Hospital (Part A) Start Date (Optional)

Medical (Part B) Start Date (Optional)

I authorize this website to electronically verify my Medicare eligibility information through a secure connection.

Eligibility Questions

Which statement best applies to you?

I am new to Medicare

I qualify for a special enrollment period (SEP)

Which statement best applies to you?

I moved to a new address that's outside of my current plan's service area, or I recently moved and this plan is a new option for me.

I was affected by an emergency or major disaster (as declared by the Federal Emergency Management Agency, or by Federal, my state or my local government). One of the other statements applied to me, but I was unable to make my request because of the disaster.

I left coverage from my employer or union (including COBRA coverage).

I was enrolled in a plan by Medicare (or my state) and I want to choose a different plan.

I recently had a change in my Extra Help paying for my drug costs (newly got Extra Help, had a change in the level of Extra Help, or lost Extra Help).

I already have Hospital (Part A) and recently signed up for Medical (Part B). I want to join a Medicare Advantage plan.

I lost other, non-Medicare drug coverage (creditable coverage), or my other non-Medicare coverage changed and is no longer considered creditable coverage.

I recently had a change in my Medicaid (newly got Medicaid, had a change in the level of Medicaid assistance, or lost Medicaid).

I recently moved out of a long-term care facility, like a nursing home or rehabilitation hospital.

I had Medicare prior to now, but I'm now turning 65.

I'm in a Medicare Advantage Plan and have had Medicare for less than 3 months. I want to make a change.

I'm in a State Pharmaceutical Program, or I am losing help from a State Pharmaceutical Assistance Program.

I am new to Medicare, and I was notified about getting Medicare after my Part A and/or Part B coverage started.

I live in a long-term care facility, like a nursing home or a rehabilitation hospital.

I am in a plan that had a star-rating less than 3 stars for the last 3 years. I want to join a plan with a star rating 3 stars or higher.

I lost my Special Needs Plan because I no longer have a condition for that plan.

I moved back to the United States after living outside the country.

I was released from jail.

(CMS decision) I lost my coverage because Medicare ended its contract with my plan. I got a letter saying I could join another plan.

I dropped my coverage in a PACE (Programs of All-Inclusive Care for the Ederly) plan.

I requested Medicare information in an accessible format. I got less time to make my decision, or I didn't get it in time to make a choice before my enrollment period ended.

I'm in a plan that was recently taken over by the state because of financial issues. I want to switch to another plan.

I recently got lawful presence status in the United States.

I signed up for Part A (Hospital Insurance) or Part B (Medical Insurance) during a Special Enrollment Period I qualified for because of an exceptional circumstance. I want to join a Medicare Advantage Plan (with or without drug coverage).

Other

You may select this if your Part A and/or Part B effective dates are in the future, or are within the last 3 months.

I moved on

Eligibility period missed

Initial enrollment period

Annual enrollment period

Special enrollment period

On

My enrollment in that plan started

On

I lost my drug coverage on

On

I moved out of the facility on

Based on the information you provided, you may not be eligible to enroll at this time. Please try a different eligibility reason or, during normal business hours, chat with us to speak with a licensed insurance agent.

Only select this if you are:
A) Currently enrolled into a Medicare Advantage Plan

AND

B) Within your first 3 months of becoming eligible for Medicare Part A and B

I was notified on

I was disenrolled from the plan on

I returned to the U.S. on

I was released on

My plan was ended on

On

My plan was taken over on

I got this status on

Date

Note the reason for your Special Election Period below. The plan carrier may contact you to determine if you're eligible.

Will you have other prescription drug coverage in addition to {carrier_name}?

Yes

No

If yes, please list your other coverage and your identification (ID) number(s) for this coverage.

Name of other coverage

ID # for this coverage

Group # for this coverage

Are you enrolled in your state's Medicaid program?

Yes

No

Medicaid number

Some description about this section

How to Pay (Optional)

Please note that you won't be billed or charged until after your application is approved. If you don't make a selection, the insurance company will send you a monthly bill. How would you like to pay your premium?

Deduct from my Social Security or Railroad Retirement

Electronic Funds Transfer (EFT) from your checking or savings account

Monthly payments by invoice

Electronic Funds Transfer (EFT) information

Account holder name (Please enter the name as it appears on the account to be debited.)

First name (Optional)

Middle name (Optional)

Last name (Optional)

Bank name (Optional)

Account number (Optional)

Routing number (Optional)

Account type (Optional)

Checking

Savings

If you need help, please call 866-508-1222 (TTY users 711) Mon – Fri, 9am – 6pm EST for licensed insurance agents who can assist with finding information on available Medicare Advantage, Medicare Supplement Insurance and Prescription Drug Plans.

We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

VBID Plans: Members may receive a monthly or quarterly allowance in the form of a benefits prepaid card to pay for a wide range of approved benefits. Unused amounts will expire at the end of the month or quarter. Transportation services may be issued as one-way trips and are provided on an annual basis.

* Depending on service provided. See Summary of Benefits for more details.

Insurance Ad – No Government Affiliation. This ad is not from the government. It’s from Insurance Benefits Group, LLC (d/b/a InsBenefitsPlaza), an independent Medicare insurance agency that sells plans from several insurance companies. The Medicare plans represented are PDP, HMO, PPO or PFFS plans with a Medicare contract. Enrollment in plans depends on contract renewal. Enrollment in a plan may be limited to certain times of the year. Eligibility may require a Special or Initial Enrollment Period. InsBenefitsPlaza and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.

By initiating a chat or scheduling a call, you are agreeing to be contacted by a licensed sales agent by email, text message or phone call (including by autodialer or prerecorded/artificial voice) to discuss information about Medicare plans. This is a solicitation for insurance. Standard messaging rates apply.

Benefits shown are for the 2026 plan year. Not all plans offer all benefits mentioned. Benefits may vary by carrier and location. Deductibles, copays, and coinsurance may apply. Limitations and exclusions may apply. $0 premium plans are not available in all areas. You must continue to pay your Part B Premium.

InsBenefit’s website is operated by Insurance Benefits Group, LLC, a licensed health insurance agency doing business as InsBenefitsPlaza. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company.

Your information and use of this site is governed by our most recent Terms of Service and Privacy Policy.

InsBenefitsPlaza is your Independent Medicare Insurance Advisor.

Company

About Us
Careers
Contact Us
Privacy Policy
Terms of Use

Resources

FAQs
Health & Wellness
Medicare 101
Prescription Drugs

Medicare Information

Eligibility Questions

How to Pay (Optional)

Company

Resources

Follow Us