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Make An AppointmentRon Gordon2021-12-27T21:44:13-06:00

Have questions or need help applying for Medicare or an ACA Insurance plan?

Schedule an Appointment with Ron!
There is no cost to call or meet with him to discuss your coverage options. Just fill out the help request form below and Ron will contact you as soon as possible. (Usually within a few hours)
HELP REQUEST FORM
Which health insurance program are you interested in?*
- Medicare
- ACA Health Insurance Marketplace®
First & Last Name*
First Last
Phone*
Email*
Home Address*
Are you currently enrolled in a federal health insurance program?*
- Yes - Medicare
- Yes - ACA Health Insurance Marketplace®
- No
- Not sure
Primary Care Physician*
Do you see any Medical specialists?
- Yes
- No
Please list all Medical specialists you see.
Preferred Hospital*
Preferred Pharmacy*
Please list all prescription medications you are CURRENTLY taking.
Annual household income? (Affordable Care Act applicants only)
Helps determine eligibility for health insurance subsidies.
Anything specific you think Ron should know about your health situation?
What type of appointment do you prefer?*
- Online (Zoom.us)
- Telephone
- In-Person
Preferred Meeting Date
Date Format: MM slash DD slash YYYY
Preferred Meeting Time

HH :

MM
How did you hear about Ron Gordon Insurance?*
- I'm an existing client
- A friend or family member referred me
- Community Event
- The Martin City Telegraph
- Radio Station
- Internet Search
- Social Media
- Other
Email
This field is for validation purposes and should be left unchanged.

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Request Help

Have questions or need help applying for Medicare or an ACA Insurance plan?

Schedule an Appointment with Ron!

HELP REQUEST FORM