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Part D Information Request Form

Available for Download Below

Downloadable Part D Info Form

  1. Download file

  2. Fill out digitally OR print and fill out

  3. Email newly filled out sheet to OR if printed mail to Mansheim Insurance Services 109 8th Street West Point, IA 52656

Please give us a call if you have any questions!

Part D - Info Form : Files
Image by National Cancer Institute

 Medicare Part D (Prescription Drug Plans)

Your Wellbeing Comes First

Every year the annual enrollment period for Part D occurs from October 15th - December 7th. During this seven week period you can review and / or switch to another drug plan that is more cost effective. 
To determine if you would like to switch, download and fill out our Part D info sheet. You can either print it or fill out your information digitally.

Part D - Info Form : Packages
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