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Collins Insurance Group

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2024 Quote / Enroll Medicare Plans

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Medication Entry Form

Please enter your First Name, Last Name, Email, and Phone number. After that please click "Continue" to enter your medications.

IF YOU SUBMITTED MEDICATIONS IN PREVIOUS YEARS AND ONLY HAVE MINOR CHANGES YOU CAN CALL THEM IN @ 414-359-1790 IF YOU WOULD LIKE.

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5124 S. 108th St, Hales Corners WI 53130 contact@collinsinsurancegroup.com | 414.359.1790

Not affiliated with the U. S. government or federal Medicare program.

We do not offer every plan available in your area. Currently, we represent six organizations which offer fifty products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

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Collins Insurance Group

Medication Entry Form

Please enter your First Name, Last Name, Email, and Phone number. After that please click "Continue" to enter your medications. IF YOU SUBMITTED MEDICATIONS IN PREVIOUS YEARS AND ONLY HAVE MINOR CHANGES YOU CAN CALL THEM IN @ 414-359-1790 IF YOU WOULD LIKE.

Please enter your First Name, Last Name, Email, and Phone number. After that please click "Continue" to enter your medications.

IF YOU SUBMITTED MEDICATIONS IN PREVIOUS YEARS AND ONLY HAVE MINOR CHANGES YOU CAN CALL THEM IN @ 414-359-1790 IF YOU WOULD LIKE.