Forms and Resources to Help You Manage Your Medicare

Medicare wants to ensure that you are treated fairly and that you are in charge of the choices you make, and you are required to fill out certain forms in order to ensure that. USA Medicare Consultants can help you understand and complete any of the following necessary forms.

Scope of Appointment Form (SOA)

This is a form required by Medicare to describe the topics you plan to discuss with USA Medicare Consultants.

Download Scope of Appointment

Permission to Contact Form (PTC)

This is a form required by Medicare that shows you give USA Medicare Consultants permission to contact you to discuss your Medicare plan options.

Download Permission to Contact

NYS EPIC Application

Application to apply for the New York State assistance program to reduce the cost of prescription drugs for the elderly.

Download Epic 2021 Plan Highlights
Download EPIC 2021 Application

Doctors & Prescriptions Form

This form will allow us to verify that your doctors and prescriptions are covered by any plan that we recommend.

Download Doctors & Prescriptions Form

Report Fraud and Abuse

Form for officially reporting evidence of Medicare fraud and abuse that you witness. USA Medicare Consultants can help you with the process of reporting Medicare fraud.

You can also report suspected Medicare fraud by:

  • Calling 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
  • If you’re in a Medicare Advantage Plan, you can call the Medicare Drug Integrity Contractor (MEDIC) at 1-877-772-3379.