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Minnesota Health Insurance

Minnesota Health Insurance Network

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Toll-Free: 1-866-664-4638   MN Local: 1-952-224-0123
Medicare Information Request
Confirmation
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In order for us to speak with you about your options, CMS (Medicare) requires that we have a signed form authorizing us to discuss your Medicare needs. This form is called a Scope of Appointment (SOA). Please click on the button below, and complete the SOA.

Scope of Appointment

IMPORTANT NOTICES AND DISCLAIMERS
This is not an application for insurance. Do not cancel any other insurance until you have received written confirmation of the new coverage. The information we collect helps us to serve your needs, provide you with personalized customer service and fulfill our legal and regulatory obligations. We do not share your information with any entities. If you choose to apply for insurance we may ask for additional required information to complete your application.