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Please do NOT use this online request to submit your prescription medication information! You will need to refer to your reminder that was mailed to you to find out how to submit that information to our office.
For MEDICAL INSURANCE available through the Affordable Care Act, please visit our ACA page by clicking here.
If you would like to be contacted regarding MEDICARE COVERAGE not listed on this website, please call us directly at 1-800-355-3381.
For MEDICARE SUPPLEMENTS and ALL OTHER inquiries, please complete this request form and click "Submit". We will contact you as soon as possible. If you would like additional information while awaiting our call, please visit our Medicare specific website by clicking here.
Any information provided will be kept strictly confidential. We do not give or sell any information to third parties. Neither Courter Financial Services, LLC, nor any of its agents are affiliated with or sponsored by the U.S. Government or Medicare. By entering your email address and/or phone number, you agree to be contacted by a licensed insurance agent in response to your inquiry.