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By submitting this form, Scott Salmon, a licensed sales agent may call or email you to discuss Medicare Advantage Plans,

Medicare Supplement Insurance and/or Prescription Drug Plans.

California License #0N05695.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.

Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.