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Part D Information Request Form
Available for Download Below
Downloadable Part D Info Form
Fill out digitally OR print and fill out
Email newly filled out sheet to firstname.lastname@example.org 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
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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