Medicare requires a Medicare beneficiary complete a Scope of Appointment before an appointment with a sales agent. The purpose is for you the Medicare Member to limit the scope of the appointment to only the products you authorized on the form. Except for unusual circumstances, the form is to be completed 48 hours before an appointment.

Signing this form does NOT obligate you to enroll in a plan, affect your current enrollment, or enroll you in a Medicare plan.

You can scan in and email the form to Raborn Insurance, fax it to 706-790-5546 or mail it to our office.

Scope of Appointment Form

Who Pays First When You Have Other Coverage

Your Guide to Preventive Services