Medicare application

Apply for Medicare Authority

Share your agency details so we can review state availability and arrange a conversation about scope. The program works with one agency per state during an active partnership. Submitting the application does not take payment and does not reserve a state.

After you apply

Three steps before any agreement

Step 1

Application review

We review the agency details you supply in the application.

Step 2

State availability check

We confirm whether the state or states you requested are open.

Step 3

Scope conversation

We arrange a conversation to discuss the next steps and agreed scope.

Submitting does not reserve a state. Payment follows an agreed scope.

Medicare application

Full name

Mobile phone

Agency name

Your current website

Referred by

Business address

City

State

ZIP code

Your FMO or upline

Are you the decision maker?

Which state do you want to own?

Any additional states you would want

Are you licensed and appointed in that state?

Is your AHIP certification current?

Roughly how many Medicare clients on your book?

What are you doing for marketing today?

Which package are you applying for?

When would you want to start?

Best time for a call

Anything we should know?

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Read about the program first

The Medicare Authority page explains what the program includes, how a build runs and the current program options.