Medicare Eligibility & Planning Assessment (Pre-65)

Medicare Eligibility & Planning Assessment (Pre-65)

Medicare Eligibility & Planning Assessment (Pre-65)

Answer these twenty questions to check eligibility, evaluate your current coverage and uncover your Medicare options. We look forward to guiding you every step of the way and helping you make confident, informed choices about your healthcare.

Step 1 of 6

Contact Information

Contact Information

Step 2 of 6

Eligibility Screening

Eligibility Screening

Are you currently receiving Social Security Disability Insurance (SSDI)?

Are you currently receiving Social Security Disability Insurance (SSDI)?

Have you been diagnosed with ALS (Amyotrophic Lateral Sclerosis)?  

Have you been diagnosed with End-Stage Renal Disease (ESRD)?

Are you currently undergoing dialysis or have you had a kidney transplant?  

Step 3 of 6

Enrollment Readiness

Enrollment Readiness

Do you know which parts of Medicare you may be eligible for (Part A, B, C, D)?

Have you reviewed your current health insurance to see how it coordinates with Medicare?

Do you understand the difference between Original Medicare and Medicare Advantage?

Have you considered whether you need prescription drug coverage (Part D)?

Do you know if you qualify for premium-free Part A?

Step 4 of 6

Planning and Support

Planning and Support

Do you have dependents or family members relying on your current health plan?

Would you like help comparing Medicare plans or understanding your next steps?

Step 5 of 6

Agent or Broker Support

Agent or Broker Support

Have you ever worked with a licensed Medicare agent or broker before?

Would you feel more confident making Medicare decisions with the help of a licensed professional?

Do you know how to verify if a Medicare agent or broker is licensed and authorized in your state?

Are you interested in receiving personalized plan comparisons from a Medicare agent or broker?

Would you like to schedule a no-cost consultation with a licensed Medicare advisor?

Step 6 of 6

Military Service and Veterans Benefits

Have you served in the U.S. military or are you currently a veteran?

Are you currently enrolled in any military-related healthcare programs such as VA Healthcare, TRICARE for Life, or CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs)?

Would you like help understanding how your VA or military benefits coordinate with Medicare coverage?

By completing this form, a licensed insurance agent from TRH Insurance may contact you by phone or email to discuss Medicare insurance options. Any email sent to or from this email address may be monitored, reviewed and archived. You can also call us to schedule an appointment: 626.600.2180; for accommodations of persons with special needs TTY:711.

Schedule an appointment today!

Get Started

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OUR OFFICE

626.542.7080

556 S. Fair Oaks Ave, #312

Pasadena, CA 91105

We serve all of Southern California, including Ventura, Los Angeles, San Bernardino, Riverside, Orange and San Diego Counties.

For accommodations for persons with special needs at meetings call TTY:711 | View our Accessibility Statement

We do not offer every plan available in your area. We currently represent [13] organizations that offer [104] products in your area. Please contact Medicare.gov, 1-800-MEDICARE or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. Not affiliated or endorsed by CMS, HHS or the federal government.

Licensed in California (0M51552), Texas (2500229), Georgia (3513345), and Nevada (4011220).


Copyright © 2025 TRH Insurance. All Rights Reserved

Schedule an appointment today!

Get Started

Logo: TRH Insurance

Follow Us

LinkedIn

Facebook

YouTube

Instagram

OUR OFFICE

626.600.2180

556 S. Fair Oaks Ave, #312

Pasadena, CA 91105

We serve all of Southern California, including Ventura, Los Angeles, San Bernardino, Riverside, Orange and San Diego Counties.

For accommodations for persons with special needs at meetings call TTY:711 | View our Accessibility Statement

We do not offer every plan available in your area. We currently represent [13] organizations that offer [104] products in your area. Please contact Medicare.gov, 1-800-MEDICARE or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options.

Licensed in California (0M51552), Texas (2500229) and Georgia (3513345). 

Schedule an appointment today!

Get Started

TRH Insurance

Follow Us

LinkedIn

Facebook

YouTube

Instagram

OUR OFFICE

626.542.7080

556 S. Fair Oaks Ave, #312

Pasadena, CA 91105

We serve all of Southern California, including Ventura, Los Angeles, San Bernardino, Riverside, Orange and San Diego Counties.

For accommodations for persons with special needs at meetings call TTY:711 | View our Accessibility Statement

We do not offer every plan available in your area. We currently represent [13] organizations that offer [104] products in your area. Please contact Medicare.gov, 1-800-MEDICARE or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. Not affiliated or endorsed by CMS, HHS or the federal government.

Licensed in California (0M51552), Texas (2500229), Georgia (3513345), and Nevada (4011220).


Copyright © 2025 TRH Insurance. All Rights Reserved