Contact

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 or Medicare number, with this form. If that information is necessary to assist you, we will ask for it during a subsequent telephone conversation.

First Name (required)

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How May We Assist You? (required)
Please do not include sensitive personal information, like your Social Security number.