Medicare Plans & Scope of Appointment

Coverage

What we cover

A full range of Medicare and related coverage, matched to your health and budget:

Medicare Advantage (Part C)

All-in-one plans that often bundle medical, drug, and extra benefits.

Part D Drug Plans

Stand-alone prescription coverage matched to the medications you take.

Medicare Supplement (Medigap)

Helps cover the gaps in Original Medicare for predictable out-of-pocket costs.

Dental Plans

Standalone dental benefits that round out your everyday coverage.

Vision Plans

Exams, frames, and lenses to protect your sight and your budget.

Hospital Indemnity

Cash benefits that help with costs if you're admitted to the hospital.

Scope of Appointment

Before we talk plans.

Complete the form to the right and a licensed FIMS specialist will follow up to schedule your review.

What is a Scope of Appointment?

A Scope of Appointment (SOA) is a federally required Medicare form you complete before meeting with a licensed agent. By listing only the product types you agree to discuss — such as Medicare Advantage (Part C) or prescription drug plans (Part D) — it keeps the conversation focused on what you want to review and protects you from high-pressure sales tactics. Completing it does not enroll you in anything and does not affect your current coverage.

Do I need one if I call you?

No. If you reach out to us first, you generally don't need an SOA on file before we talk. We'll only have you complete one when we schedule a separate appointment to review specific plans.

Complete your form

Scope of Appointment

Tell us which Medicare topics you'd like to discuss. It takes about a minute, and there's no obligation to enroll.

Products to discuss

Select each product type you'd like the agent to discuss with you. *

Medicare Advantage (Part C)All-in-one medical & drug plans Prescription Drug Plans (Part D)Stand-alone drug coverage Medicare Supplement (Medigap)Gap coverage for Original Medicare Dental PlansStandalone dental benefits Vision PlansExams, frames & lenses Hospital IndemnityCash benefits if hospitalized

Your information

Full name *

Phone *

Email *

Relationship to beneficiary

Address (street, city, state, ZIP)

Medicare ID number (optional)

Initial method of contact

Agreement & signature By checking this box and typing my name below, I agree to a meeting with a licensed FIMS Assurance Group sales agent to discuss the product types I selected above. I understand the agent may be paid based on my enrollment, that there is no obligation to enroll, that my current or future Medicare enrollment will not be affected, and that I will not be automatically enrolled in any plan. My electronic signature is legally valid under the E-Sign Act. Type your full name to sign *

Signature date:

We do not offer every plan available in your area. Any information we provide is limited to the plans we offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048), 24 hours a day / 7 days a week, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. Scope of Appointment documentation is subject to CMS record-retention requirements.

Medicare made simple.

What we cover

Medicare Advantage (Part C)

Part D Drug Plans

Medicare Supplement (Medigap)

Dental Plans

Vision Plans

Hospital Indemnity

Before we talk plans.

What is a Scope of Appointment?

Do I need one if I call you?

Scope of Appointment

Have questions first?