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Contact Claim

Have a question about Medicare or the CLAIM program? Use this form to contact us at any time. This form will send an e-mail to CLAIM and we will respond as soon as possible.

CLAIM always respects your privacy and will never sell your information. It will only be made available to a certified counselor or staff of CLAIM as necessary to assist you. See our privacy policy for more information.

Note: Please do not send us personal information, such as your social-security number, with this form. If that information is necessary to assist you, we will ask for it during a subsequent telephone conversation.

Describe your request here. Please do not include any sensitive personal information, like your Social Security number.

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