Skip to Content
I am Shopping for Medicare
I am a SummaCare Secure Member
Search
Find Your Doctor or Hospital >
Find Your Drug >
Find Your Pharmacy >
Contact Us >
Request More Information >
Home
>
Request More Information
>
Order Medicare Booklet
Request MEDICARE Booklet
YES! Send my FREE copy of Medicare. I understand that I am under no obligation.
*
First Name
*
Last Name
Phone Number
Email Address
*
Address
*
City
*
State
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachussetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virgina
Wisconsin
Wyoming
*
Zip
*
County
Select a County
Ashtabula
Carroll
Columbiana
Cuyahoga
Erie
Geauga
Huron
Lake
Lorain
Mahoning
Medina
Portage
Sandusky
Stark
Summit
Trumbull
Tuscarawas
Wayne
*
Date of Birth
*
How did you hear about SummaCare?
Select
Direct Mail
Family/Friend
Newspaper
Other
Television
Website
*
What coverage do you currently have?
Select
Original Medicare+Part D
Original Medicare (No Part D)
Aetna MAPD
Anthem MAPD
Humana MAPD
Hometown-MAPD
Primetime (Aultcare) MAPD
Medical Mutual MAPD
Kaiser MAPD
Secure Horizons (UnitedHealthcare) MAPD
Other
*Required Field